Endocrine Abstracts

Advances in understanding the pathogenesis of autoimmune diseases is leading to development of new targeted therapies, with the resultant improvements in the management of the patients. Autoimmunity to the TSH receptor is the main cause of Graves’ disease and components of this disorder are the extrathyroidal complications which include Graves’ ophthalmopathy and pretibial dermopathy. Recent studies in Graves’ ophthalmopathy implicate an additional target antigen in the orbital fibroblasts, the IGF-1 receptor whose activation by autoantibodies may lead to the cascade of cytokine and chemokines secretion leading to orbital inflammation and swelling. Thus, potential immunomodulatory approaches that target the immune system by focusing on the autoreactive plasma B cell secreting autoantibodies may have beneficial effects to bring therapeutic benefit to the patient. Such immunomodulatory studies are well advanced in terms of clinical phase trails in a number of B cell autoimmune disorders. This talk will highlight the variety of new targeted therapies that are beginning to come to fruition, such as B cell depleting and modulating monoclonal antibodies, interference with B cell survival factors, anti-cytokine therapies and cellular therapies including regulatory T cells and dendritic cells. Their potential translation to treatment and management of Graves’ ophthalmopathy will be also be discussed.