ArticleThyroid research2026
A preliminary study developing a scoring model incorporating fibrinogen-like protein 2 for predicting glucocorticoid resistance in thyroid eye disease.
Article in Thyroid research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveIntravenous glucocorticoids are the first-line therapy for moderate-to-severe active thyroid eye disease (TED), but some patients demonstrate steroid resistance. Therefore, identifying reliable pre-treatment biomarkers to predict the therapeutic response to intravenous glucocorticoids is of considerable clinical importance.
methodsIn the discovery phase, pre-treatment serum samples from 10 patients with TED treated with intravenous glucocorticoids (six responders, four non-responders), along with samples from three patients with Graves’ disease without TED and three healthy controls, were subjected to data-independent acquisition proteomics analysis. Candidate biomarkers were validated in an expanded cohort (21 responders, 10 non-responders, 14 Graves’ disease patients, and 14 healthy controls).
resultsData-independent acquisition proteomics analysis revealed 263 differentially abundance proteins between responders and non-responders. Among them, transforming growth factor-β, heparanase, and fibrinogen-like protein 2 were identified as potential biomarker candidates. In the validation phase, only fibrinogen-like protein 2 was significantly elevated in non-responders. Although fibrinogen-like protein 2 alone achieved an area under the curve of 0.76, Least Absolute Shrinkage and Selection Operator regression incorporating clinical parameters identified smoking and high thyroid-stimulating antibody as additional predictors. A three-factor scoring system (fibrinogen-like protein 2 > 39.5 ng/mL, thyroid-stimulating antibody > 2597%, and current smoking; each 1 point) yielded an area under the curve of 0.86, with good reproducibility in bootstrap validation.
conclusionsElevated pre-treatment serum fibrinogen-like protein 2 is a promising biomarker for predicting steroid resistance in TED. Combining fibrinogen-like protein 2 with thyroid-stimulating antibody and current smoking provides a clinically useful scoring system to guide personalized treatment.
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