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The Thyroid Gland01:23

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The thyroid gland is a small, butterfly-shaped gland located in the neck and covers the anterior surface of the trachea. The gland has two lateral lobes connected by a thin tissue mass called the isthmus. Internally, each lobe comprises many small spherical structures known as thyroid follicles, surrounded by a network of blood vessels.
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The thyroid hormone (TH) plays a pivotal role in the intricate orchestration of physiological processes, exerting profound effects on development, metabolism, and homeostasis throughout different life stages.
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Low blood levels of the thyroid hormones — triiodothyronine (T3) and thyroxine (T4) — signal the hypothalamus to release the thyrotropin-releasing hormone (TRH). TRH then reaches the pituitary gland and stimulates the release of thyroid-stimulating hormone(TSH) into the bloodstream.
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The muscles of the eye are sophisticated structures that control eye movement and focus, allowing for the precise and rapid adjustments necessary for vision. The human eye is controlled by ten muscles — six extraocular muscles, three intraocular muscles, and one primary eyelid retractor muscle.
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Optical perception, or vision, is an extraordinary sense dependent on converting light signals received via the ocular organs. These organs, known as eyes, are securely positioned within the bony cavities of the skull, called orbits. The orbits serve a dual purpose: a protective shield for the ocular globes and a stable attachment point for the soft ocular tissues. The eye's external protective mechanisms include the eyelids, which are edged with lashes that act as a barrier against foreign...
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Light rays enter the eye through the cornea, a transparent dome-shaped tissue that is the eye's outermost layer. The cornea bends or refracts, light rays traveling to the pupil. The shape of the cornea determines how much of the light is bent and whether the image will be focused correctly on the retina at the back of the eye. Once the light has passed through both refraction layers, it converges into a single focal point onto a small area. This is where photoreceptors start transforming...
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Generation of a Mouse Spontaneous Autoimmune Thyroiditis Model
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Tocilizumab for thyroid eye disease.

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Currently, no randomized controlled trials demonstrate tocilizumab

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Area of Science:

  • Ophthalmology
  • Immunology
  • Rheumatology

Background:

  • Thyroid eye disease (TED) is a challenging autoimmune disorder with limited effective treatments.
  • Interleukin-6 (IL-6) plays a role in TED pathogenesis, suggesting IL-6 inhibition as a potential therapy.
  • There is an unmet need for treatments that can modify TED's course and prevent long-term complications.

Purpose of the Study:

  • To investigate the efficacy and safety of tocilizumab for treating thyroid eye disease.
  • To assess tocilizumab's impact on TED inflammatory responses and disease progression.

Main Methods:

  • A systematic literature search was conducted across multiple databases (CENTRAL, MEDLINE, Embase, etc.) up to July 2018.
  • Searched for randomized controlled trials comparing tocilizumab with placebo or glucocorticoids for TED.
  • Planned outcomes included TED score, proptosis, extraocular motility, quality of life, and adverse events.

Main Results:

  • No studies met the inclusion criteria for this review.
  • One relevant randomized controlled trial (NCT01297699) was identified but awaits data availability.
  • This trial investigates tocilizumab in moderate-to-severe Graves' ophthalmopathy unresponsive to corticosteroids.

Conclusions:

  • There is currently no evidence from randomized controlled trials to support the efficacy or safety of tocilizumab for thyroid eye disease.
  • Further research, including the awaited data from NCT01297699, is needed to evaluate tocilizumab's role in TED treatment.