Alterations in Esophageal MicroRNAs Expression in Primary Esophageal Achalasia by Next-Generation Sequencing

Abstract

Background: Molecular knowledge regarding the primary esophageal achalasia is essential for early diagnosis and treatment of this neurodegenerative motility disorder. So, there is a need to find the main microRNAs (miRNAs) contributing to the mechanisms of achalasia.Methods: This study was conducted to determine some patterns of deregulated miRNAs in the achalasia. This case-control study was performed on 52 patients with achalasia and 50 non-achalasia controls. The miRNA expression profiling was conducted on the esophageal tissue samples obtained from the patients with achalasia and non-achalasia patients controls using the Next-Generation Sequencing (NGS). Differential expression of miRNAs was analyzed by the edgeR software. The selected dysregulated miRNAs were additionally confirmed using the quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR). Potential target genes of the downregulated and upregulated miRNAs were also predicted to understand the putative role of the miRNAs in the development of the achalasia. Results: Totally, 15 miRNAs were identified that were significantly altered in the tissues of the patients with achalasia compared to the controls. Among them, three miRNAs including miR-133a-5p, miR-143-3p, and miR-6507-5p were upregulated. Also, six miRNAs including miR-215-5p, miR-216a-5p, miR-216b-5p, miR-217, miR-7641, and miR-194-5p were downregulated significantly. The predicted targets for the dysregulated miRNAs showed significant disease-associated pathways like neuronal cell apoptosis, neuromuscular balance, nerve growth factor signaling, and immune response regulation. Gene expression analysis confirmed significant downregulation of the hsa-miR-217 (p-value = 0.004) in the Lower Esophageal Sphincter (LES) of the patients with achalasia with significant enrichment in the myelination process ontology. The results of this study provide the first integrated miRNA expression profile in the achalasia using the NGS. Our findings introduced 15 candidate miRNAs as achalasia-associated non-coding RNAs and also confirmed the downregulation of the hsa-miR-217 in the achalasia disease. Conclusions: Our results may serve as a basis for more future functional studies to investigate the role of candidate miRNAs in the etiology of achalasia and their application in diagnosis and probably treatment of the disease.