IGF-1R在甲状腺相关眼病中的作用机制及靶向治疗进展  

The mechanism of IGF-1R in thyroid-associated ophthalmopathy and progress in targeted therapy

作　　者：周莹 程献[2] 高芸[1] 包建东[1] 陈侃[1] Zhou Ying;Cheng Xian;Gao Yun;Bao Jiandong;Chen Kan

机构地区：[1]江苏省原子医学研究所附属江苏省江原医院内分泌科,无锡214063 [2]江苏省原子医学研究所

出　　处：《临床眼科杂志》2023年第5期474-479,共6页Journal of Clinical Ophthalmology

基　　金：江苏省健计委面上项目(M2021060);无锡市科技局项目(Y20212052)。

摘　　要：甲状腺相关眼病(TAO)是一种潜在的威胁视力的眼病,目前临床上采用的糖皮质激素、免疫抑制药物、眼眶局部放射及手术治疗等方法均未针对TAO的发病机制进行治疗。近年来研究发现眼眶成纤维细胞中的胰岛素样生长因子-1受体(IGF-1R)活性增强引起透明质酸合成增多,导致TAO的发生,而抑制IGF-1R的活性可以减弱或阻断信号通路。替妥木单抗(Teprotumumab)作为治疗性的靶向IGF-1R拮抗剂,药物临床试验表明此药物能够显著降低TAO的活动性、严重程度、改善疾病的临床结局,并且具有良好的安全性和持久性。因此,替妥木单抗是从病因学角度治疗TAO的新方法,值得临床医生给予更多关注。Thyroid associated ophthalmopathy(TAO)is s a potentially sight-threatening ocular disease.Currently glucocorticoids,immunosuppressive drugs,orbital local radiation and surgical treatment have not been used to target the pathogenesis of the disease,these efficacy are not suboptimal.It has been confirmed that increased activity of insulin-like growth factor-1 receptor(IGF-1R)in orbital fibroblasts(OFs)leads to increased hyaluronic acid synthesis,which is possible the mechanism of TAO.Inhibition of IGF-IR activity leads to attenuate or block the signaling pathway.As a therapeutic antagonist targeting IGF-1R,Teprotumumab could dramatically reduce the activity and severity of TAO,improve the clinical outcome of the disease,and had good safety and durability.Therefore,Teprotumumab is a novel treatment method for TAO from the perspective of etiology,and deserves more attention from clinicians.

关 键 词：甲状腺相关性眼病 胰岛素样生长因子-1受体 替妥木单抗 

分 类 号：R771.3[医药卫生—眼科] R581[医药卫生—临床医学]