Cytokines and drugs targeting cytokines in Graves' disease and thyroid eye disease

Graves' disease (GD) is an autoimmune disorder characterized by the production of stimulatory autoantibodies against the thyrotropin receptor, leading to hyperthyroidism and diffuse goiter. The most frequent extrathyroidal manifestation is Graves' ophthalmopathy (GO), also known as thyroid eye disease (TED), which is responsible for significant morbidity due to orbital inflammation, tissue remodeling, and visual impairment. In recent years, increasing evidence has demonstrated that cytokines play a central role in both GD and TED, orchestrating immune cell activation, autoantibody production, fibroblast stimulation, and tissue remodeling. The evolving understanding of cytokine networks has reshaped disease models and paved the way for targeted therapies that interfere with specific immune pathways. We review the immunepathogenesis of GD and TED, the role of cytokine networks, and the available cytokine-targeted therapies.