MicroRNAs versus traditional biomarkers in predicting reperfusion injury in Hepatitis C Patients after major surgery

Abstract

Background: Exposure to anesthesia in patients with chronic hepatitis C (CHC) may induce hepatic ischemia / reperfusion (I/R) with subsequent biochemical changes, provoked by alteration in molecular processes. This study explored miR-122 and miR-223 expression changes induced by anesthesia in CHC patients and their role in predicting hepatic I/R injury. Methods:This study included two hundered ASA II -III adult patients, scheduled for major surgery under general anesthesia. Patients were divided into 2 main groups; CHC patients group and non-hepatitis patients group. Each group was further divided into 2 equal subgroups (50 patients each) according to type of anesthesia received either Sevoflurane SC /S or Propofol PC/P ). Blood samples were analyzed for liver enzymes, prothrombin time, and serum lactate at several intervals; preoperative, 12 and 48 hours postoperative. Also, plasma miR-122 and miR-223 were estimated by Reverse Transcription PCR preoperative and 12 hours postoperative.Results: CHC groups showed significantly increased preoperative expression of both miR-122 and miR-223 compared to non-hepatitis groups (P<0.05). Moreover, postoperative samples revealed more exaggerated expression miR-122 and miR-223. Receiver operating characteristic curve (ROC) results revealed;values for area under the ROC for miR-122, miR-223, ALT and serum Lactate were 0.991, 0.965, 0.746 and 0.732 respectively. Based on the ROC finding, for prediction IR in CHC patients receiving anesthesia miR-122 had best Accuracy, sensitivity, and specificity. Conclusion:Our results suggested that both miR-122 and miR-223 could be regarded as more sensitive and specific biomarkers for predicting hepatic I/R injury than traditional biomarkers particularly in CHC patients undergoing major surgery.