Potential Value of miR-23a for Discriminating Neuromyelitis Optica Spectrum Disorder from Multiple Sclerosis

Abstract

Background: Until now, no laboratory test or test set can guarantee the diagnosis of multiple sclerosis (MS) at early disease stages, and the disease symptoms may interfere with many other disease conditions. Analyzing the expression of circulating miRNAs may provide a useful approach for early and differential MS diagnosis. The main objective is assessment of the potential of serum miR-23a, miR-155, and miR-572 to differentiate between MS and other neuroinflammatory diseases. Methods: Serum miRNAs were obtained from 37 MS patients and 25 healthy age-matched controls, along with patients with neuromyelitis optica spectrum disorder (NMOSD) [n = 13] and neuropsychiatric systemic lupus erythematosus (NPSLE) [n = 10]. miRNA expression levels were analyzed using real-time polymerase chain reaction (PCR) and pairwise comparisons were made to reveal the diagnostic/distinguishing potential of the analyzed miRNAs. Results: In the study cohort, the three investigated miRNAs failed to display significant dysregulation in MS patients. However, they could significantly discriminate patients with NMOSD and NPSLE [median (IQR): 8.1 (6.1–9.2) and 8.8 (7.9–9.7) for miR-23a, 7.5 (5.3–8.3) and 8.0 (7.5–9.5) for miR-155 and 6.9 (5.0–8.8) and 6.4 (5.3–8.8) for miR-572 in NMOSD and NPSLE, respectively] from healthy subjects [median (IQR): 3.4 (1.5–4.3), 3.1 (1.1–5.6) and 3.5 (1.7–5.6) for miR-23a, miR-155 and miR-572, respectively], with area under the curve (AUC) ≤0.8. Remarkably, miR-23a has been emerging as a prospective biomarker for differentiation of MS from NMOSD as well as NPSLE (AUC<0.9). The miRNA combined use contributed to enhanced diagnostic and discriminatory performance in the study groups. Conclusion: Certain miRNA expression levels would contribute to discriminating MS from other neuroinflammatory diseases.

Biomarkers in Neuropsychiatric Systemic Lupus Erythematosus: A Systematic Literature Review of the Last Decade

“…Mutations in the TREX1 gene have been linked to several diseases, including SLE and Aicardi-Goutières syndrome (AGS), a rare neurological condition that is characterized by its onset in early childhood and bears some clinical resemblance with SLE [ 45 ]. Emerging epigenetic biomarkers in NPSLE that have displayed satisfactory ability to discriminate between NPSLE and controls (healthy individuals or other neurological diseases) include microRNA (miR)-23a (AUC: 0.95–0.98; p < 0.001 for all) [ 46 ] and miR-155 (AUC: 0.76–0.92; p < 0.05 for all) [ 46 ]. MicroRNAs (miRNAs) are short single-stranded RNA molecules that regulate gene expression through degradation of messenger RNAs [ 47 ] and have been indicated to have a role in disease mechanisms of SLE in recent epigenetic research [ 48 , 49 ].…”

The role and mechanisms of Microglia in Neuromyelitis Optica Spectrum Disorders

“…It has been indicated that microRNAs (miRNAs) are significantly altered in the whole blood of NMOSD patients when compared to MS patients 69 , 70 , while long noncoding RNAs (lncRNAs), the another kind of ncRNA, are differentially expressed in peripheral blood mononuclear cells (PBMCs) of NMOSD patients compared to those of controls 71 . Circulating miRNAs from whole blood, as well as serum exosomal miRNAs, might serve as potential biomarkers for the diagnosis and prognosis of NMOSD 72 , 73 , and several miRNAs are also capable of discriminating NMOSD from MS or neuropsychiatric systemic lupus erythematosus (NPSLE) 74 , 75 . It has been revealed that different kinds of ncRNAs (miRNAs 76 , lncRNAs 77 , circular RNAs (circRNAs) 78 , etc.)…”