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A therapeutic protocol for Graves' disease consisting of the antithyroid drug methimazole combined with ultrasound-guided intrathyroid injections of dexamethasone (IID). Developed by Dr. Xiao-Ming Mao at the Affiliated Nanjing First Hospital of Nanjing Medical University, this regimen targets the intrathyroidal autoimmune response to reduce the high relapse rates typically seen with standard oral antithyroid drug monotherapy. Dexamethasone, a small molecule corticosteroid, is injected directly into the thyroid lobes to modulate local immune activity, specifically by improving the function of regulatory T cells (Tregs), restoring the Th1/Th2 balance, and suppressing the expression of pro-inflammatory chemokines like CCL2 and CXCL10. Clinical trials have demonstrated that this combination significantly lowers the relapse rate of hyperthyroidism in Graves' patients compared to methimazole alone.
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