Investigation of periostin, il-4 and il-13 levels in graves disease

Objectıve: The most common non-thyroidal manifestation of Graves' disease, which is the most common cause of hyperthyroidism, is orbitopathy. Propitosis is the main characteristic of Graves' orbitopathy, which is caused by the proliferation of extraocular muscles and the expansion of orbital fat and connective tissue within the bones. We aimed to investigate the role of orbital fibroblast inflammation, the periostin protein involved in fibrosis mechanisms, IL-4, and IL-13 cytokines in the pathogenesis of Graves' ophthalmopathy. Data and Method: After obtaining ethical approval, a total of 75 individuals were included in the study: 25 patients diagnosed with Graves' disease and associated orbitopathy (Group 1), 25 patients diagnosed with Graves' disease without orbitopathy (Group 2), and 25 healthy volunteers without thyroid disease with normal thyroid function test results (Group 3). Human Periostin ELISA Kit (Bioassay Technology Laboratory, catalog no: E3226Hu), Human Interleukin 4 ELISA Kit (Bioassay Technology Laboratory, catalog no: E0092Hu), and Human Interleukin 13 ELISA Kit (Bioassay Technology Laboratory, catalog no: E0098Hu) were used to analyze the collected blood samples. Significant differences were observed in the study outcomes. Results: Among the three groups included in the study, there were no significant differences in age, gender, height, weight, BMI, systolic and diastolic blood pressure, glucose, urea, creatinine, ALT, WBC, Hgb, and PLT parameters. Significant differences were found in thyroid hormone levels (fT4 and TSH) and autoantibody levels (TRAb) between the groups (p<0.001, p<0.001, and p=0.001, respectively). TSH levels in Group 1 and Group 2 were significantly lower compared to Group 3 (p=0.001 and p<0.001, respectively). TRAb levels were significantly higher in Group 1 and Group 2 compared to Group 3 (both p<0.001). FT4 levels in Group 1 and Group 2 were significantly higher compared to Group 3 (both p=0.001). The primary focus of our study, periostin, IL-4, and IL-13 data, were significantly elevated in the group with Graves' ophthalmopathy compared to others (all p<0.001). Periostin levels were significantly higher in Group 1 compared to Group 2 and Group 3 (p=0.001 and p<0.001, respectively). Group 2 had significantly higher periostin levels than Group 3 (p=0.02). IL-4 levels in Group 1 were significantly higher compared to Group 2 and Group 3 (both p<0.001). Group 2 had significantly higher IL-4 levels than Group 3 (p=0.01). IL-13 levels in Group 1 were significantly higher compared to Group 2 and Group 3 (p=0.002 and p<0.001, respectively). Group 2 had significantly higher IL-13 levels than Group 3 (p=0.04). Conclusıon: Periostin, IL-4, IL-13 levels were found higher in the patient with Graves' ophthalmopathy compared to the healthy people and the graves patients without ophthalmopathy. In patients with grave disease without ophthalmopathy, level of periostin, IL-4 and IL-13 were found higher compared to the healthy individuals. The blood measurements of periostin, IL-4 and IL-13 illustrate that they can be used as biomarkers to early diagnosis for the graves' ophthalmopathy. We suggest that the antagonists of these parameter could contribute to the treatments of the ophthalmopathy. However, further investigation on this subject is necessary.