Circulating miR-146a predicts glucocorticoid response in thyroid eye disease

Area of Science:

• Ophthalmology
• Endocrinology
• Immunology

Background:

• Thyroid eye disease (TED) is an immune-mediated condition affecting the eyes.
• Intravenous glucocorticoids (GC) are a primary treatment for moderate-to-severe active TED, but response rates vary (50-80%).
• Predictive markers for GC responsiveness in TED are lacking.

Purpose of the Study:

• To investigate the potential of miR-146a and miR-21 as biomarkers for predicting GC treatment response in TED patients.
• To identify factors associated with GC responsiveness in active moderate-to-severe TED.

Main Methods:

• A prospective longitudinal study included 30 adult patients with active moderate-to-severe TED receiving standard IV methylprednisolone.
• Response to GC was defined by a reduction in clinical activity score (CAS) or CAS <4/10 at 24 weeks.
• Serum circulating microRNAs (miRNAs), including miR-146a and miR-21, were quantified using real-time PCR.

Main Results:

• A significant 77% of patients responded to GC therapy.
• Higher pre-treatment levels of circulating miR-146a, along with thyroid surgery history, higher CAS, and greater proptosis, predicted GC responsiveness.
• Receiver operating characteristic (ROC) analysis indicated miR-146a has a 100% positive predictive value for GC responsiveness.

Conclusions:

• This study identifies pre-treatment circulating miR-146a as a novel, objective biomarker for predicting GC sensitivity in TED.
• miR-146a can potentially guide clinicians in selecting appropriate GC therapy, avoiding ineffective treatments for TED patients.