Proteomic and Clinical Characterization of Active vs. Quiescent Pterygium With Elevated Thrombospondin-1

To investigate proteomic and clinical changes in active- and quiescent-stage pterygium and identify biomarkers.

This study included 15 and 14 patients with quiescent- and active-stage pterygium, respectively. Clinical parameters (length, area, thickness, vessel density, and hemodynamics) were assessed using slit-lamp, anterior segment-optical coherence tomography angiography, and functional slit-lamp biomicroscopy. Label-free proteomics was performed on excised tissues. Thrombospondin-1 (THBS1) was validated via enzyme-linked immunosorbent assay, immunohistochemistry, and reverse transcription quantitative polymerase chain reaction. Correlation and receiver operating characteristic analyses were also conducted.

Compared with the quiescent stage, active pterygium exhibited significantly greater corneal invasion length, area, thickness, and vessel density, along with reduced vessel length. Proteomic analysis revealed 7 upregulated differentially expressed proteins whose pathways were mainly immune related and 15 downregulated differentially expressed proteins. THBS1 was significantly elevated in active tissue, confirmed by enzyme-linked immunosorbent assay, strong immunohistochemical staining, and higher messenger RNA levels. Receiver operating characteristic analysis supported THBS1 as a potential biomarker, yielding an area under the curve of 0.81 for distinguishing active-stage pterygium.

Immune dysregulation and neovascularization may play an important role in pterygium progression. THBS1 may serve as a potential biomarker for predicting pterygium development and monitoring its progression.

This work translates the discovery of elevated thrombospondin-1 into a potential clinical biomarker, bridging proteomic findings to the assessment of pterygium activity.