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中华眼科医学杂志(电子版) ›› 2026, Vol. 16 ›› Issue (01) : 59 -64. doi: 10.3877/cma.j.issn.2095-2007.2026.01.011

综述

甲状腺眼病生物治疗的研究进展
方成彦, 梁博昱, 李倩, 李妍†()   
  1. 650000　昆明，云南大学附属医院（云南省第二人民医院、云南省眼科医院）　云南省眼部疾病临床医学研究中心　云南省眼病临床医学中心
  • 收稿日期:2026-01-15 出版日期:2026-02-28
  • 通信作者: 李妍
  • 基金资助:
    国家自然科学基金项目(82360202，82460201)

Research advances in biological therapy for thyroid eye disease

Chengyan Fang, Boyu Liang, Qian Li, Yan Li†()   

  1. Yunnan University Affiliated Hospital (Yunnan Second People′s Hospital, Yunnan Eye Hospital) Yunnan Clinical Medical Research Center for Eye Diseases Yunnan Clinical Medical Center for Eye Diseases, Kunming 650000, China
  • Received:2026-01-15 Published:2026-02-28
  • Corresponding author: Yan Li
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方成彦, 梁博昱, 李倩, 李妍. 甲状腺眼病生物治疗的研究进展[J/OL]. 中华眼科医学杂志(电子版), 2026, 16(01): 59-64.

Chengyan Fang, Boyu Liang, Qian Li, Yan Li. Research advances in biological therapy for thyroid eye disease[J/OL]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2026, 16(01): 59-64.

甲状腺眼病(TED)是Graves病常见且具有代表性的甲状腺外表现，是一种以眼眶组织炎症、脂肪增生和纤维化为主要病理特征的器官特异性自身免疫性疾病，可对患者视功能与生活质量造成显著损害。近年来，有关其发病机制的认识已取得关键突破，尤其是促甲状腺激素受体(TSHR)与胰岛素样生长因子-1受体(IGF-1R)信号交叉对话网络的阐明，直接推动了靶向生物治疗的革命性发展。本文中笔者系统综述TED从自身免疫启动到组织重塑的级联反应机制，重点阐述TSHR/IGF-1R信号轴、免疫细胞浸润及免疫微环境调控的核心作用；全面梳理以IGF-1R为靶点的单克隆抗体Teprotumumab为代表的已上市生物制剂及其他新兴疗法的临床研究证据并就当前TED治疗面临的主要挑战进行讨论；展望涵盖多组学指导的个体化治疗、嵌合抗原受体-T细胞疗法及抗纤维化治疗策略等未来精准医疗的发展方向，旨在为TED的临床决策与转化研究提供参考。

关键词: 甲状腺眼病, Graves眼病, 免疫发病机制, 胰岛素样生长因子-1受体, 生物治疗, 靶向治疗, 免疫检查点

Thyroid ophthalmopathy (TED) is a common and representative extra thyroid manifestation of Graves′ disease. It is an organ specific autoimmune disease characterized by orbital tissue inflammation, fat hyperplasia, and fibrosis, which can cause significant damage to patients′ visual function and quality of life. In recent years, key breakthroughs have been made in the understanding of its pathogenesis, especially in the elucidation of the signaling cross dialogue network between thyroid stimulating hormone receptor (TSHR) and insulin-like growth factor receptor (IGF), which directly promotes the revolutionary development of targeted biological therapy. The cascade reaction mechanism of TED from autoimmune initiation to tissue remodeling, with a focus on the core roles of TSHR/IGF-1 signaling axis, immune cell infiltration, and immune microenvironment regulation were systematically reviewed in this paper; the clinical research evidence of marketed biologics and other emerging therapies, represented by the monoclonal antibody Tepotumumab targeting IGF-1R were comprehensively sorted out and the main challenges faced by current TED therapy were discussed; the future development directions of precision medicine were prospected, including personalized treatment guided by multiple omics, chimeric antigen receptor T-cell (CAR-T) therapy, and anti fibrotic treatment strategies, aiming to provide reference for TED′s clinical decision-making and translational research.

Key words: Thyroid Eye Disease, Graves′ orbitopathy, Immunopathogenesis, Insulin-like growth factor-1 receptor, Biologic therapy, Targeted therapy, Immune checkpoint
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