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REVIEW ARTICLE
Year : 2022  |  Volume : 12  |  Issue : 1  |  Page : 3-11

Thyroid eye disease: From pathogenesis to targeted therapies


1 Department of Ophthalmology, The Institute of Vision Research, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea; Division of Oculofacial Plastic and Reconstructive Surgery, University of California San Diego, California, United States of America
2 Division of Oculofacial Plastic and Reconstructive Surgery, University of California San Diego, California, United States of America

Correspondence Address:
Dr. Jin Sook Yoon
Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722

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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjo.tjo_51_21

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Thyroid eye disease (TED) is the most common extrathyroidal manifestation of autoimmune Graves' hyperthyroidism. TED is a debilitating and potentially blinding disease with unclear pathogenesis. Autoreactive inflammatory reactions targeting orbital fibroblasts (OFs) lead to the expansion of orbital adipose tissues and extraocular muscle swelling within the fixed bony orbit. There are many recent advances in the understating of molecular pathogenesis of TED. The production of autoantibodies to cross-linked thyroid-stimulating hormone receptor and insulin-like growth factor-1 receptor (IGF-1R) activates OFs to produce significant cytokines and chemokines and hyaluronan production and to induce adipocyte differentiation. In moderately severe active TED patients, multicenter clinical trials showed that inhibition of IGF-1R with teprotumumab was unprecedentedly effective with minimal side effects. The emergence of novel biologics resulted in a paradigm shift in the treatment of TED. We here review the literature on advances of pathogenesis of TED and promising therapeutic targets and drugs.


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