MicroRNAs as Clinical Biomarkers and Therapeutic Tools in Perioperative Medicine

Abstract

Over the past decade, evolutionarily conserved, noncoding small RNAs-so-called microRNAs (miRNAs)-have emerged as important regulators of virtually all cellular processes. miRNAs influence gene expression by binding to the 3'-untranslated region of protein-coding RNA, leading to its degradation and translational repression. In medicine, miRNAs have been revealed as novel, highly promising biomarkers and as attractive tools and targets for novel therapeutic approaches. miRNAs are currently entering the field of perioperative medicine, and they may open up new perspectives in anesthesia, critical care, and pain medicine. In this review, we provide an overview of the biology of miRNAs and their potential role in human disease. We highlight current paradigms of miRNA-mediated effects in perioperative medicine and provide a survey of miRNA biomarkers in the field known so far. Finally, we provide a perspective on miRNA-based therapeutic opportunities and perspectives.

MicroRNA-194 promotes lineage plasticity in advanced prostate cancer

“…Supporting our findings, FOXA1 has been previously identified as a target of miR-194 in non-small cell lung cancer (NSCLC); interestingly, in this context it appeared to act as a tumour suppressor, with upregulation of miR-194 suppressing tumour proliferation, invasion and metastasis (57). The reported), while a miR-155 antagomiR is in phase I trials for lymphoma (63). The attraction of targeting miRNAs in cancer comes from the potential to concurrently modulate multiple pathways involved in tumour growth and progression.…”

MicroRNA Involvement in Signaling Pathways During Viral Infection

“…Also, in chimpanzees with chronic HCV infection the silencing of miR-122 by the antisense oligonucleotide Miravirsen was also achieved, and long lasting viral suppression was observed (Lanford et al, 2010). 3 years later, Janssen et al carried out a second phase of the study in chronic HCV infected patients who received 5weekly injections of Miravirsen, and they observed that the treatment resulted in a prolonged and dose-dependent reduction in HCV RNA levels (Janssen et al, 2013;van der Ree et al, 2014;Kreth et al, 2018). More recently, the evaluation of miR-122 plasma levels in chronic HCV infected patients during Miravirsen treatment demonstrated a specific, significant and prolonged decrease in miR-122 expression, very close to detection limits in some cases.…”

MicroRNAs 143 and 150 in whole blood enable detection of T-cell immunoparalysis in sepsis

“…In sepsis, recent publications reported altered expression of specific miRNAs. The authors suggested individual or sets of miRNAs as biomarkers to enable an early diagnosis, to differentiate different sepsis severity grades, and/or to predict survival (reviewed in (Kreth et al 2017 )). Results of these studies, however, were remarkably heterogeneous, and a consensus with respect to actually suitable biomarkers has not been reached so far.…”