血清外泌体源性microRNA对类风湿性关节炎的诊断意义

Diagnostic significance of serum exosome derived microRNA in rheumatoid arthritis

目的探讨血清外泌体源性microRNA(exomiR)-24-3p、exomiR-125a-5p和exomiR-144-3p诊断类风湿性关节炎(RA)的价值。方法提取124例RA患者(RA组)和100例健康体检者(对照组)的血清外泌体。实时荧光定量PCR法检测2组患者血清中exomiR-24-3p、exomiR-125a-5p和exomiR-144-3p表达水平。用受试者工作特征(ROC)曲线分析血清外泌体exomiR诊断RA的价值;Pearson法分析exomiR与28个关节疾病活动度评分(DAS28)、红细胞沉降率(ESR)、C反应蛋白(CRP)的相关性;比较不同活动度RA患者血清exomiR表达水平。结果与对照组比较,RA组患者血清exomiR-24-3p和exomiR-144-3p表达水平较高,而exomiR-125a-5p表达水平较低(P<0.05)。ROC曲线结果显示,血清exomiR-24-3p、exomiR-125a-5p和exomiR-144-3p诊断RA的曲线下面积(AUC)分别为0.703、0.824、0.736,灵敏度分别为94.89%、96.23%、93.01%,特异度分别为75.01%、85.88%、82.14%;三者联合检测的AUC为0.889,灵敏度为97.23%,特异度为90.12%。血清exomiR-24-3p、exomiR-144-3p与DAS28、ESR、CRP均呈正相关(P<0.05);exomiR-125a-5p与DAS28、ESR、CRP均呈负相关(P<0.05)。单因素分析结果显示,不同疾病活动度RA患者的exomiR-24-3p、exomiR-125a-5p、exomiR-144-3p表达水平比较,差异具有统计学意义(P<0.05),疾病活动度越高,exomiR-24-3p和exomiR-144-3p表达水平越高,而exomiR-125a-5p表达水平越低。结论血清exomiR-24-3p、exomiR-125a-5p和exomiR-144-3p对RA的诊断有较高价值,可以评估疾病活动度。

Objective To investigate the value of serum exosome-derived microRNA(exomiR)-24-3p,exomiR-125a-5p and exomiR-144-3p in the diagnosis of rheumatoid arthritis(RA).Methods Serum exosomes were extracted from 124 RA patients(RA group)and 100 healthy people(control group).The expression levels of serum exomiR-24-3p,exomiR-125a-5p and exomiR-144-3p of patients in two groups were detected by real-time fluorescence quantitative PCR.Receiver operating characteristic(ROC)curve was used to analyze the value of serum exomiR in the diagnosis of RA.Pearson method was used to analyze the correlation between exomiR and disease activity score in 28 joints(DAS28),erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP).The expression levels of serum exomiR in RA patients with different activity were compared.Results Compared with the control group,the expression levels of serum exomiR-24-3p and exomiR-144-3p in the RA group were higher,while the expression level of exomiR-125a-5p was lower(P<0.05).The results of ROC curve analysis showed that the areas under the curve(AUC)of serum exomiR-24-3p,exomiR-125a-5p and exomiR-144-3p for diagnosing RA were 0.703,0.824,and 0.736,respectively,and the sensitivities were 94.89%,96.23%,and 93.01%,respectively,the specificity were 75.01%,85.88%,and 82.14%,respectively.The AUC of combined detection of the three indicators was 0.889,the sensitivity was 97.23%,and the specificity was 90.12%.Serum exomiR-24-3p and exomiR-144-3p were positively correlated with DAS28 score,ESR and CRP respectively(P<0.05);exomiR-125a-5p was negatively correlated with DAS28 score,ESR and CRP respectively(P<0.05).The results of univariate analysis showed that there were significant differences in the expression levels of exomiR-24-3p,exomiR-125a-5p and exomiR-144-3p of RA patients with different disease activity(P<0.05).The higher the disease activity,the higher the expression levels of exomiR-24-3p and exomiR-144-3p,while the lower the expression level of exomiR-125a-5p.Conclusion Serum exomiR-24-3p,exomiR-125a-5p and exomiR-144-3p have high diagnostic value for RA and can assess the disease activity.