血浆外泌体microRNA-29c在阿尔茨海默病早期诊断价值的初步研究

The preliminary study on the diagnostic value of plasma exosomes microRNA-29c in the early diagnosis of the Alzheimer's disease

目的初步探讨血浆外泌体内microRNA-29c(miR-29c)在阿尔茨海默病(AD)早期诊断种的价值。方法明确血浆外泌体内miR-29c提取和检测过程的稳定性;检测202例轻度认知障碍(MCI)和痴呆期(DAT)AD患者及120例表面健康受试者的血浆外泌体内miR-29c,建立其生物参考区间,确定截断值,比较其诊断效能。结果对照组、帕金森患者、血管性痴呆患者、MCI和DAT患者miR-29c的回收率均在95%-105%之间,且各组受试者间的回收率无统计学差异(P>0.05);MCI和DAT患者血浆外泌体内miR-29c均显著低于对照组、帕金森患者和血管性痴呆患者(P<0.05),且DAT患者显著低于MCI患者(P<0.05);对照组、帕金森患者和血管性痴呆患者血浆外泌体内miR-29c水平无显著性差异(P>0.05);使用截断值诊断MCI和DAT的灵敏度高于生物参考区间法(P>0.05)。结论外泌体内miR-29c可作为AD诊断,特别是早期诊断的候选生物标志物,且应使用其截断值而不是生物参考区间对AD进行早期诊断。

Objective To investigate the value of microRNA-29 c（miR-29 c）in the early diagnosis of Alzheimer＇s disease（AD）in plasma exosomes.Methods The stability of the extraction and detection of miR-29 cin plasma exosomes was clarified.The expression of miR-29 cin plasma exosomes in 202 patients with mild cognitive impairment（MCI）and dementia（DAT）and 120 healthy controls-29 c,establish its biological reference interval,determine the cut-off value,compare its diagnostic efficacy.Results The recovery of miR-29 cin control group,Parkinson＇s disease,vascular dementia,MCI and DAT patients were between 95% and 105%,and there was no significant difference between the two groups（P〉0.05）.The levels of miR-29 cin plasma exosomes in MCI and DAT patients were significantly lower than those in control group,Parkinson＇s disease patients and vascular dementia patients（P〈0.05）,and those in DAT patients were significantly lower than those in MCI patients（P〈0.05）.There was no significant difference in the level of miR-29 cin the plasma exosomes between patients with Parkinson＇s disease and those with vascular dementia（P〉0.05）.The sensitivity of using the cutoffs to diagnose MCI and DAT was higher than that of the biological reference interval method（P〉0.05）.Conclusion MiR-29 cin exosomes can be used as a candidate biomarker for the diagnosis of AD,especially for early diagnosis,and early diagnosis of AD should be performed using its cutoff instead of the biological reference interval.