Project description:Orbital fibrosis is a hallmark of tissue remodeling in thyroid-associated ophthalmopathy (TAO). Previous studies have shown that interleukin (IL)-11 plays a pivotal profibrotic role in various inflammatory and autoimmune diseases. However, the expression pattern of IL-11 in patients with TAO and whether IL-11 is mechanistically linked with pathological fibrosis remains unknown. In this study, we investigated IL-11 levels in the serum and orbital connective tissue of patients with TAO, and evaluated the correlation of these levels with the patient’s clinical activity score. We also evaluated the expression pattern of IL-11Rα in orbital connective tissue. Furthermore, we elucidated the regulatory factors, profibrotic function, and downstream signaling pathways for IL-11 in TAO using in vitro studies. Serum and orbital connective tissues IL-11 levels were increased in patients with TAO, as compared with healthy controls. In addition, both levels were positively correlated with disease activity. Single-cell RNA sequencing of orbital connective tissue indicated that IL-11Rα was dominantly expressed in orbital fibroblasts (OFs). RNA sequencing of paired unstimulated and transforming growth factor (TGF)-β1-stimulated samples demonstrated that upregulation of IL-11 expression defined the dominant transcriptional response. IL-11 signaling was also confirmed to be downstream of TGF-β1 and IL-1β. Therefore, we deduced that IL-11 protein is secreted in an autocrine loop in TAO. We also indicated that IL-11 mediated the profibrotic phenotype switch by detecting the expression of myofibroblast differentiation markers, including α-smooth muscle actin and collagen type I α1, which could be abrogated by an anti-IL-11 neutralizing antibody. Furthermore, we revealed that extracellular regulated protein kinase may be a crucial factor in the pro-fibrotic, translationally specific signaling activity of IL-11. These data demonstrate that IL-11 plays a crucial role in orbital fibroblast phenotype switching and may be a potential therapeutic target candidate for the treatment of TAO.

Project description:Thyroid eye disease (TED) is an orbital autoimmune disease which severely affects vision, appearance, and quality of life. TED is the most common extrathyroidal manifestation of Graves' disease, which is mainly featured by hyperthyroidism. Current assessments of TED severity and activity, do not effectively guide regimen, especially the selection of target agents. Peripheral blood samples from 161 TED patients and 20 Graves' hyperthyroidism (GH) patients without eye disease were collected for transcriptome sequencing, and corresponding clinical information was systematically compiled. We then comparatively derived a unique gene expression profile for TED compared to GH, and based on this, unsupervised clustering of TED patients using ConsensusClusterPlus was conducted. Next, immune infiltration analysis, weighted gene co-expression network analysis (WGCNA), hub gene screening, and drug sensitivity analysis were performed for different clusters. TED exhibited elevated of autoantigens, immune responses, cellular proliferation, and metabolic disorders than GH. A novel two-cluster classification scheme was established for TED, independent of classical assessment of severity and activity. Cluster 1 patients received more intravenous glucocorticoids and surgeries but experienced less pain and excessive tearing. They had higher peripheral blood lymphocytes, including CD4+ T cells, CD8+ T cells, T follicular helper cells, natural killer cells, and B cells, than cluster 2 patients. WGCNA identified cluster-related gene modules, and least absolute shrinkage and selection operator (LASSO) regression analysis yielded six hub genes (DDR2, LRP1B, NTRK2, PALB2, PTPRD, and SLC25A6) for cluster 1 and three hub genes (MON2, SNORA74B, and STX16) for cluster 2 as potential biomarkers. Considering current TED therapies, cluster 1 patients may prefer insulin-like growth factor 1 receptor (IGF-1R) antibodies, while cluster 2 patients may favor glucocorticoids. We described the specific gene profile of TED compared to GH and built a new molecular classification of TED patients into two clusters with different immune infiltration, hub genes, and drug sensitivity. It paves the way for improved application of precision medicine in TED.

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Transcriptomic Profiling of Thyroid Eye Disease Orbital Fibroblasts

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