Hepatology:miRNA- seq鉴定了一个血清miRNA,结合APRI可以检测和监测存在囊性纤维化中的儿童肝病

2018-07-30 MedSci MedSci原创

本研究在儿科CFLD中发现了一种独特的循环miRNA,它有可能准确鉴别儿童CF患者的肝脏疾病和纤维化严重程度。

研究背景:囊性纤维化(Cystic fibrosis, CF)相关肝病(CFLD)是CF的一种肝胆并发症。目前的诊断模式依赖于非特异性评估,而肝活检是评估纤维化严重程度的黄金标准。MicroRNAs (miRNAs)调控肝脏疾病的发生,被认为是一种诊断生物标志物。本研究评估了血清miRNAs和天冬氨酸氨基转移酶/血小板比率(APRI)诊断和评估CFLD的严重程度的效能。

研究方法:本研究是一项横断面研究,评估124例儿童循环miRNA水平,按临床、生化和影像学进行分组。如下:CFLD患者 (n=44),CF患者无肝病(CFnoLD, n=40)和健康对照组(n=40)。采用miRNA-sequencing检测血清miRNAs水平。通过qRT-PCR进一步验证所选的差异表达血清miRNA候选体;以肝穿为标准,采用统计学方法评估血清miRNAs单独或联合APRI预测病死率和纤维化程度的有效性。

研究结果:相比CFnoLD患者,CFLD患者中血清miR-122-5p、miR-365a-3p和miR-34a-5p水平升高;然而miR-142-3p和let-7g-5p等水平在CFLD中较CFnoLD下调。Logistic回归分析显示,miR-365a-3p、miR-142-3p和let-7g-5p联合APRI,准确预测CF患者肝病的概率是前者的21倍(敏感性为83%,特异性为92%;P < 0.0001)。血清miR-18a-5p的表达水平与CFLD (rs =0.56, P<0.0001)增加的肝纤维化阶段相关,在鉴别重度(F3-4)与轻度/中度纤维化(F0-2)时,具有良好的诊断准确性。miR-18a-5每增加一个单位水平,发生严重纤维化的几率增加7倍,AUROC=0.82(敏感性=93%,特异度=73%;P=0.004),显示其预测纤维化严重程度的潜力。

研究结论:本研究在儿科CFLD中发现了一种独特的循环miRNA,它有可能准确鉴别儿童CF患者的肝脏疾病和纤维化严重程度。

原始出处:

Calvopina DA, Chatfield MD, Weis A, et al. miRNA-Seq identifies a serum miRNA panel, which combined with APRI can detect and monitor liver disease in paediatric Cystic Fibrosis. Hepatology, 2018 Jul 16. doi: 10.1002/hep.30156.

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    2018-08-11 wolongzxh
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    2019-06-01 hbwxf
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    2018-12-30 smallant2002
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    2018-08-01 Homburg
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    2018-08-01 gwc384

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