Increased plasma levels of soluble programmed death ligand 1 (sPD-L1) and fibroblast growth factor 23 (FGF-23) in patients with Graves' ophthalmopathy in comparison to hyperthyroid patients without Graves' ophthalmopathy

Cytokine. 2023 Sep:169:156269. doi: 10.1016/j.cyto.2023.156269. Epub 2023 Jun 10.


Background: Management of Graves' ophthalmopathy (GO) is still a challenge in Graves' disease (GD). Moreover, 40% of GD patients show radiological muscle enlargement without clinically apparent GO. Delayed treatment of GO may lead to deterioration in prognosis.

Methods: Thirty GD patients with overt hyperthyroidism were included in this study, 17 of whom either had GO at diagnosis or developed GO during the study period. Samples were collected at the beginning of the study, at 6 months, and at 24 months. Plasma samples were analyzed for 92 cytokines using the Olink Target 96 inflammation panel.

Results: After adjustment for multiplicity testing using the false discovery rate approach, soluble programmed death ligand 1 (sPD-L1) and fibroblast growth factor 23 (FGF-23) were significantly elevated in GO patients.

Conclusion: Using a broad cytokine panel we show that patients with Graves' ophthalmopathy have elevated PD-L1 and FGF-23 levels. The findings support previous suggestions that PD-L1 may serve as a treatment target.

Keywords: Cytokines; FGF-23; Graves’ disease; Graves’ ophthalmopathy; Humans; Orbit/metabolism/pathology programmed cell death 1 receptor/metabolism; Thyroid associated ophthalmopathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • B7-H1 Antigen
  • Fibroblast Growth Factor-23
  • Graves Disease*
  • Graves Ophthalmopathy*
  • Humans
  • Hyperthyroidism*


  • CD274 protein, human
  • B7-H1 Antigen
  • Fibroblast Growth Factor-23