The combination of these cytokines, TNFα plus IFNγ, simulates Graves thyrocytes and orbital fibroblasts to produce CXC alpha-chemokine CXCL10/IP-10 which plays an important role in the initiation of GO.35 These observations suggest that retrobulbar cell types from GO patients participate in self-perpetuation of inflammation by releasing chemokines under the influence of cytokines. This evidence concerns the gene CXCL10 and geroderma osteodysplastica.