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Hodgkin lymphoma (HL) and diffuse large B cell lymphoma (DLBCL) represent 15% and 20%, respectively, of all lymphoma types. The aim of this study was to identify and compare circulating serum miRNA (c-miRNA) and peripheral whole blood miRNA (wb-miRNA) profiles in patients with these lymphomas. Serum samples (20 HL, 21 DLBCL, and 30 healthy controls) and whole blood samples (21 HL, 17 DLBCL patients, and 30 healthy controls) were collected at the time of diagnosis. Serum and whole blood were also collected from 18 HL/17 DLBCL and eight HL/nine DLBCL patients, respectively, after treatment. Pairwise comparisons identified 125 c-miRNAs (adjusted P value < 0.05) showing significant dysregulation between 30 healthy controls and patients; of these, 47 and 55 differentiated controls from pretherapeutic HL and DLBCL patients, respectively. In addition, 60 and 16 c-miRNAs differentiated controls from posttherapeutic HL and DLBCL, respectively. Pairwise comparisons identified 292 wb-miRNAs (adjusted P value < 0.05) showing significant dysregulation between 30 controls and patients; of these, 103 and 169 differentiated controls from pretherapeutic HL and DLBCL, respectively, and 142 and 151 wb-miRNAs differentiated controls from posttherapeutic HL and DLBCL, respectively. Thus, lymphoma-associated miRNAs may be a better source of noninvasive candidate biomarkers than miRNAs in serum. It is unclear whether miRNA alterations in lymphoma cells are similar to those observed in white blood cells.

Objective: This study aimed to characterize the miRNA expression profiles from plasma samples of our local breast cancer patients in comparison to healthy control by using miRNA PCR Array. Methods: In this study, plasma miRNA profiles from eight early-stage breast cancer patients and nine age-matched (± 2 years) healthy controls were characterized by miRNA array-based approach, followed by differential gene expression analysis, Independent T-test and construction of Receiver Operating Characteristic (ROC) curve to determine the capability of the assays to discriminate between breast cancer and the healthy control. Results: Based on the 372-miRNAs microarray profiling, a set of 40 differential miRNAs was extracted regarding to the fold change value at 2 and above. We further sub grouped 40 miRNAs of breast cancer patients that were significantly expressed at 2-fold change and higher. In this set, we discovered that 24 miRNAs were significantly upregulated and 16 miRNAs were significantly downregulated in breast cancer patients, as compared to the miRNA expression of healthy subjects. ROC curve analysis revealed that seven miRNAs (miR-125b-5p, miR-142-3p, miR-145-5p, miR-193a-5p, miR-27b-3p, miR-22-5p and miR-423-5p) had area under curve (AUC) value > 0.7 (AUC p-value < 0.05). Overlapping findings from differential gene expression analysis, ROC analysis, and Independent T-Test resulted in three miRNAs (miR-27b-3p, miR-22-5p, miR-145-5p). Cohen’s effect size for these three miRNAs was large with d value are more than 0.95. Conclusion: miR-27b-3p, miR-22-5p, miR-145-5p could be potential biomarkers to distinguish breast cancer patients from healthy controls. A validation study for these three miRNAs in an external set of samples is ongoing.

Hadeel A Al-Rawaf,1,2 Ahmad H Alghadir,1 Sami A Gabr1 1Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia; 2Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi ArabiaCorrespondence: Sami A GabrRehabilitation Research Chair (RRC), King Saud University, Riyadh, Kingdom of Saudi ArabiaTel +966562060018Fax +96614698541Email dr.samigabr@gmail.comBackground: The release of miRNAs in tissue fluids significantly recommends its use as non-invasive diagnostic biomarkers for the progression and pathogenesis of mild cognitive impairment (MCI) in aged patients.Objective: The potential role of circulated miRNAs in the pathogenesis of MCI and its association with cellular oxidative stress, apoptosis, and circulated BDNF, Sirtuin 1 (SIRT1), and dipeptidyl peptidase-4 (DPP4) were evaluated in older adults with MCI.Methods: A total of 150 subjects aged 65.4± 3.7 years were recruited in this study. The participants were classified into two groups: healthy normal (n=80) and MCI (n=70). Real-time PCR analysis was performed to estimate the relative expression of miRNAs; miR-124a, miR-483-5p, miR-142-3p, and miR-125b, and apoptotic-related genes Bax, Bcl-2, and caspase-3 in the sera of MCI and control subjects. In addition, oxidative stress parameters; MDA, NO, SOD, and CAT; as well as plasma DPP4 activity, BDNF, SIRT1 levels were colorimetrically estimated.Results: The levels of miR-124a and miR-483-5p significantly increased and miR-142-3p and miR-125b significantly reduced in the serum of MCI patients compared to controls. The expressed miRNAs significantly correlated with severe cognitive decline, measured by MMSE, MoCA, ADL, and memory scores. The expression of Bax, and caspase-3 apoptotic inducing genes significantly increased and Bcl-2 antiapoptotic gene significantly reduced in MCI subjects compared to controls. In addition, the plasma levels of MDA, NO, and DPP4 activity significantly increased, and the levels of SOD, CAT, BDNF, and SIRT1 significantly reduced in MCI subjects compared to controls. The expressed miRNAs correlated positively with NO, MDA, DPP4 activity, BDNF, and SIRT-1, and negatively with the levels of CAT, SOD, Bcl-2, Bax, and caspase-3 genes.Conclusion: Circulating miR-124a, miR-483-5p, miR-142-3p, and miR-125b significantly associated with severe cognitive decline, cellular oxidative stress, and apoptosis in patients with MCI. Thus, it could be potential non-invasive biomarkers for the diagnosis of MCI with high diagnostic performance.Keywords: circulating miRNAs, MCI, biomarkers, cellular oxidative stress, apoptosis, real-time RT-PCR

Aim: Some clinical and biological characteristics have been described as prognostic factors for clinical conversion into clinically definite multiple sclerosis in radiologically isolated syndrome (RIS) population. The aim of this study was to assess signatures of circulating miRNAs in those patients according to their conversion status after 5 years of follow-up. Patients & methods: OpenArray plates assessing 216 miRNA candidates were run in 15 RIS patients, and their relative abundances were analyzed. Results: A specific profile of deregulated circulating miRNAs (miR-144-3p, miR-448 and miR-653-3p in cerebrospinal fluid and miR-142-3p, miR-338-3p, miR-363-3p, miR-374b-5p, miR-424-5p, miR-483-3p in plasma) differentiated individuals who remained as RIS after 5 years of follow-up. Conclusion: Circulating miRNAs might be used as prognostic biomarkers for RIS patients.

Despite the significant improvements in advanced melanoma therapy, there is still a pressing need for biomarkers that can predict patient response and prognosis, and therefore support rational treatment decisions. Here, we investigated whether circulating miRNAs could be biomarkers of clinical outcomes in patients treated with targeted therapy. Using next-generation sequencing, we profiled plasma miRNAs at baseline and at progression in patients treated with BRAF inhibitors (BRAFi) or BRAFi + MEKi. Selected miRNAs associated with response to therapy were subjected to validation by real-time quantitative RT-PCR. Receiver Operating Characteristics (ROC), Kaplan–Meier and univariate and multivariate Cox regression analyses were performed on the validated miR-1246 and miR-485-3p baseline levels. The median baseline levels of miR-1246 and miR-485-3p were significantly higher and lower, respectively, in the group of patients not responding to therapy (NRs) as compared with the group of responding patients (Rs). In Rs, a trend toward an increase in miR-1246 and a decrease in miR-485-3p was observed at progression. Baseline miR-1246 level and the miR-1246/miR-485-3p ratio showed a good ability to discriminate between Rs and NRs. Poorer PFS and OS were observed in patients with unfavorable levels of at least one miRNA. In multivariate analysis, a low level of miR-485-3p and a high miR-1246/miR-485-3p ratio remained independent negative prognostic factors for PFS, while a high miR-1246/miR-485-3p ratio was associated with an increased risk of mortality, although statistical significance was not reached. Evaluation of miR-1246 and miR-485-3p baseline plasma levels might help clinicians to identify melanoma patients most likely to be unresponsive to targeted therapy or at higher risk for short-term PFS and mortality, thus improving their management.

Alemtuzumab is a monoclonal antibody targeting CD52, used as induction therapy after lung transplantation (LTx). Its engagement produces a long-lasting immunodepletion; however, the mechanisms driving cell reconstitution are poorly defined. We hypothesized that miRNAs are involved in this process. The expression of a set of miRNAs, cytokines and co-signaling molecules was measured with RT-qPCR and flow cytometry in prospectively collected serum samples of LTx recipients, after alemtuzumab or no induction therapy. Twenty-six LTx recipients who received alemtuzumab and twenty-seven matched LTx recipients without induction therapy were included in the analysis. One year after transplantation four miRNAs were differentially regulated: miR-23b (p = 0.05) miR-146 (p = 0.04), miR-155 (p p p p p

The present study aimed to identify the differential expression profiles of microRNAs in the plasma between patients with preeclampsia (PE) and healthy pregnancies using quantitative real-time PCR. The expression profiles of 32 miRNAs in maternal plasma from 31 patients with PE and 32 healthy pregnancies were evaluated. The expression levels of eight miRNAs including miR-210, miR-375, miR-197-3p, miR-132-3p, miR-29a-3p, miR-328, miR-24-3p, and miR-218-5p were significantly upregulated and the expression levels of three miRNAs, including miR-302b-3p, miR-191-5p, and miR-17-5p, were significantly downregulated in patients with preeclampsia when compared to healthy pregnant women. In conclusion, we identified 11 miRNAs that may be potential biomarkers for non-invasive diagnosis and a pivotal role in the prediction of PE. Considering the small cohort of patients, further studies with larger samples from different gestational stages are necessary to confirm our findings.IMPACT STATEMENT

Circulating non-coding RNAs (ncRNAs) possess high stability in circulation, making them capable of being utilized in the diagnosis, prognosis, and treatment of upper gastrointestinal (GI) tract cancers.Herein, the potential clinical application of emerging circulating miRNAs and lncRNAs in upper GI cancers are comprehensively reviewed.For esophageal cancer (EC), the circulating miRNAs, miR-21, miR-223, and miR-375 have been validated as promising diagnostic biomarkers in a meta-analysis. For gastric cancer (GC), miR-17, miR-18a, miR-21, miR-25, miR-223, miR-451, and lncRNA-H19 have been reported in several studies and are likely to be promising biomarkers. Unlike EC, many circulating lncRNAs have been newly reported for GC and each is often limited to one study. They show excellent or outstanding discrimination performance, such as XIST, LOC100506474, UCA1, LINC00467, ZNFX1-AS1, HULC, AA174084, CEBPA-AS1, MIAT, PCSK2-2:1, HOTTIP, H19 (AUCs 0.8 to 0.9), and particularly CUDR, LSINCT-5, PTENP1, HOTAIR, and LncRNA-GC1 (AUCs0.9). Most importantly, using a group of ncRNAs as a diagnostic panel would give a more promising diagnostic or prognostic performance. However, different clinical trials and large, multi-center cohorts as well as comprehensive meta-analyses should also be conducted to validate and use emerging circulating ncRNAs as the indicators of GI cancers.

Type 2 diabetes is the most prevalent metabolic disease worldwide. The disease is characterised by high blood glucose levels and recently it has been shown that changes in the plasma levels of several miRNAs (miRNA) are associated with the disease. Interestingly, alterations in circulating miRNAs occur years before the onset of the disease and demonstrate predictive power. In this study, we carried out RT-qPCR to examine the plasma levels of two type 2 diabetes specific miRNAs, miR-30d-5p and miR-126-3p in an Iranian population of non-diabetic control individuals, subjects with intermediate hyperglycaemia and type 2 diabetic individuals with hyperglycaemia. We found that the plasma levels of miR-30d and miR-126 increase by 3.1 and 11.16 times, respectively, in individuals with intermediate hyperglycaemia compared to non-diabetic controls. However, no significant changes in the expression of these two miRNAs have been observed between type 2 diabetic individuals and non-diabetic subjects. Our results confirm that alterations in the plasma levels of miR-30d-5p and miR-126-3p could be used as diagnostic markers of type 2 diabetes in the Iranian population as well.

Rationale. Cardiovascular diseases remain the leading cause of human death in the world. Studying the role of regulatory non-coding RNAs, which include short single-stranded miRNA molecules, allows a more detailed understanding of the pathological processes underlying the progression of atherosclerosis. Objective to compare the levels of circulating miRNAs in patients with coronary heart disease, confirmed by multislice computed tomography-coronarography (MSCT-CA), with risks of cardiovascular complications and clinical and demographic characteristics. To compare the profiles of circulating miRNAs in groups of patients with stable and unstable atherosclerotic plaques. Methods. MicroRNA levels in the plasma of peripheral blood of patients with coronary heart disease were determined using the miScript miRNA PCR Array MIHS-105Z kit (Qiagen). The significance of differences in miRNA levels between the compared groups was determined using the MannWhitney U-test. The correlations of the levels of circulating miRNAs with clinical and demographic parameters were evaluated using the Spearman correlation coefficient. Risk assessment of cardiovascular complications in these patients was carried out using validated scales (ACC/AHA, Framinghm, SCORE, MESA). Atherosclerotic plaque stability was evaluated using MSCT-CA. Results. The study showed a significant (p 0.05) decrease in miR-16, miR-211, miR-195 miRNA levels in the plasma of patients with coronary heart disease, which correlated with an increase in cardiac vascular risk (CVR) according to ACC/AHA, Framingham and MESA. When comparing groups of patients with stable and unstable atherosclerotic plaques, the latter revealed an increase in the level of let-7b-5p circulating microRNA (p 0.05). Conclusion. Significant associations of the three studied microRNAs with the estimated risk of CVR were identified. It is important to find circulating let-7b-5p in a group of patients with unstable atherosclerotic plaques. Correlations were established between the levels of circulating microRNAs and clinical and demographic characteristics of patients. The study shows the involvement of some microRNAs in the regulation of atherosclerosis.

Background:Circulating miRNAs have been proved to be promising biomarkers for disease detection in recent years. The present study aimed at exploring available serum miRNA biomarkers for the detection of colorectal cancer.Methods:A three-phase study was performed to select and validate candidate miRNAs with significant dysregulation in colorectal cancer using quantitative reverse transcription-polymerase chain reaction. This study recruited 137 colorectal cancer patients and 145 healthy controls. The diagnostic values of miRNAs were evaluated by receiver operating characteristic analysis. Bioinformatics analyses were utilized to predict target genes of miRNAs, and to conduct functional annotation and enrichment.Results:miR-30e-3p, miR-31-5p, miR-34b-3p and miR-146a-5p, miR-148a-3p and miR-192-5p were significantly dysregulated in colorectal cancer serum when compared with healthy controls. The panel composed of miR-30e-3p, miR-146a-5p, and miR-148a-3p exhibited strong diagnostic ability. The area under the receiver operating characteristic curve of the three-miRNA panel was 0.883, with a sensitivity of 0.800 and specificity of 0.787.Conclusion:The present study identified a three-miRNA panel in serum with a strong diagnostic ability of colorectal cancer, which may be able to serve as a novel noninvasive biomarker for colorectal cancer detection.

Rationale: Inhaled corticosteroids (ICS) are key treatments for controlling asthma and preventing asthma attacks. However, the responsiveness to ICS varies among individuals. MicroRNAs (miRNAs) hav...

Background Cancer colon is one of the leading causes of death and MiRNAs are incorporated in biological pathways that affect tumorigenesis as proved by multiple studies. The present study aimed to investigate whether miR-17-3p is elevated in the plasma free samples of colon cancer patients in correlation with other tumor markers (CEA, CA19.9). Results MiRNA 17-3P plasma free sample levels were significantly elevated in the plasma free samples of colon cancer patients compared with healthy controls (P < 0.001); on the other hand, serum levels of CA19.9 were significantly higher in colon cancer patients compared to healthy controls while serum levels of CEA were found to be of no statistical significance. Conclusion The detection miRNA-17-3p may be considered of clinical value for the detection of colon cancer; also, CA19.9 detection was found to significantly increase the sensitivity and specificity of a colon cancer diagnosis.

Background: Authors aimed to investigate the clinical role of miR-21 and miR-181 among glioblastoma multiforme (GBM) patients.Materials and methods: Expression for both miRs were detected in blood samples from newly diagnosed twenty GBM patients before and after treatment along with 20 healthy individuals using QPCR technology.Results: MiR-21 reported increase expression while miR-181 reported decreased expression in GBM patients. Expression of miR-21 was up-regulated in GBM patients older than 60 years and frontal mass with tumor size > 5 cm while miR-181 expression was down-regulated among them. Worse PFS and OS reported increase in miR-21 expression and decrease in miR-181 expression.Conclusion: Detection of miR-21 and miR-181 expression levels may be a potential diagnostic and predictors for GBM prognosis.

Circulating miRNAs are novel biomarkers, authors aimed to investigate the expression level of miR-29a and miR-335 and their relevance to CEA, CA15.3, and matrix metalloproteinase-2 (MMP2).Breast cancer (BC) patients (Expression of miR-29a and miR-335 were significantly decreased in breast patients as compared to healthy individuals, while biochemical markers were high in BC patients as compared to the other two groups. The diagnostic efficacy for miR-29a, miR-335, and MMP2 were superior to both CEA and CA 15.3 for early detection of BC patients.Detection of the miR-29a and miR335 expression levels in serum samples are significant promising biomarkers for BC diagnosis.

Circulating miRNAs (c-miRNAs) are promising biomarkers for HF diagnosis and prognosis. There are no studies on HF pediatric patients undergoing VAD-implantation. Aims of this study were: to examine the c-miRNAs profile in HF children; to evaluate the effects of VAD on c-miRNAs levels; to in vitro validate putative c-miRNA targets. c-miRNA profile was determined in serum of HF children by NGS before and one month after VAD-implant. The c-miRNA differentially expressed were analyzed by real time-PCR, before and at 4 hrs,1,3,7,14,30 days after VAD-implant. A miRNA mimic transfection study in HepG2 cells was performed to validate putative miRNA targets selected through miRWalk database. Thirteen c-miRNAs were modified at 30 days after VAD-implant compared to pre-VAD at NSG, and, among them, six c-miRNAs were confirmed by Real-TimePCR. Putative targets of the validated c-miRNAs are involved in the hemostatic process. The in vitro study confirmed a down-regulatory effect of hsa-miR-409-3p towards coagulation factor 7 (F7) and F2. Of note, all patients had thrombotic events requiring pump change. In conclusion, in HF children, the level of six c-miRNAs involved in the regulation of hemostatic events changed after 30 days of VAD-treatment. In particular, the lowering of c-miR-409-3p regulating both F7 and F2 could reflect a pro-thrombotic state after VAD-implant.

Background Cardiovascular disease (CVD) represents a complex pathophysiological condition with continuous increasing mortality and poor treatment outcome. Troponin is the only standard biochemical indication of CVD, which fails to exactly determine the diagnostic and prognostic indications of CVD. Circulating microribonucleic acids (miRNAs) represent crucial molecular targets to determine the pathophysiology of CVD. Hence, in the present study quantitative estimation of three miRNAs (miRNA-133, miRNA-155, and miRNA-222) targeting different pathways of CVD pathogenesis has been performed to find their role. Methods and Materials A total of 50 female subjects including 25 CVD patients and 25 controls with age range of 18 to 65 years were included in this study. The extraction of circulating miRNAs was done in all the serum samples separated through centrifugation. Relative expression of all three miRNAs was performed using SYBR green–based real-time polymerase chain reaction (RT-PCR) in comparison to internal control. Results Significantly upregulated expression levels were observed for miRNA-133 and miRNA-222 in CVD women patients as compared with control subjects. Age-wise analysis revealed highly upregulated expression of miRNA-133 in patients having age group 250 ng/L troponin group. Conclusion Circulating miRNAs specifically miRNA-133 and miRNA-222 have essential role in pathogenesis of CVD in women patients.

Objectives In the context of the scarcity of biomarkers for knee osteoarthritis (OA), we examined the associations of prevalent and incident OA with the expression levels of serum miRNAs in subjects with and without OA. Methods With a next-generation sequencing approach, we compared the miRome expression of 10 women with knee OA and 10 age-matched healthy subjects. By real-time qPCR, we analyzed the expression levels of 19 miRNAs at baseline selecting 43 women with prevalent knee OA (Kellgren Lawrence score of 2/3), 23 women with incident knee OA over a 4-year follow-up and 67 healthy subjects without prevalent or incident OA matched for age and body mass index. Results Serum miR-146a-5p was significantly increased in the group of prevalent knee OA compared with controls (relative quantification (RQ); median [Interquartile range] 1.12 [0.73; 1.46] vs 0.85 [0.62; 1.03], p = 0.015). The likelihood of prevalent knee OA was significantly increased (odds ratio [95% confidence interval (CI)] 1.83 [1.21–2.77], p = 0.004) for each quartile increase in serum miR-146a-5p. The women with miR-146a-5p levels above the median (0.851) had a higher risk of prevalent knee OA compared to those below the median [95% CI] 4.62 [1.85–11.5], p = 0.001. Moreover, we found a significant association between the baseline level of serum miR-186-5p and the risk of incident knee OA (Q4 vs Q1–3; odds ratio [95% CI] 6.13 [1.14–32.9], p = 0.034). Conclusion We showed for the first time that miR-146a-5p and miR-186-5p are significantly associated with prevalent and incident knee OA, respectively.

Myasthenia gravis (MG) is an autoimmune neuromuscular disease characterized by fatigable skeletal muscle weakness with a fluctuating unpredictable course. One main concern in MG is the lack of objective biomarkers to guide individualized treatment decisions. Specific circulating serum microRNAs (miRNAs) miR-30e-5p, miR-150-5p and miR-21-5p levels have been shown to correlate with clinical course in specific MG patient subgroups. The aim of our study was to better characterize these miRNAs, regardless of the MG subgroup, at an early stage from diagnosis and determine their sensitivity and specificity for MG diagnosis, as well as their predictive power for disease relapse. Serum levels of these miRNAs in 27 newly diagnosed MG patients were compared with 245 healthy individuals and 20 patients with non-MG neuroimmune diseases. Levels of miR-30e-5p and miR-150-5p significantly differed between MG patients and healthy controls; however, no difference was seen compared with patients affected by other neuroimmune diseases. High levels of miR-30e-5p predicted MG relapse (p = 0.049) with a hazard ratio of 2.81. In summary, miR-150-5p is highly sensitive but has low specificity for MG, while miR-30e-5p has the greatest potential as a predictive biomarker for the disease course in MG, regardless of subgroup.

[ES] La presente tesis doctoral, titulada "papel del miR-99a-5p en cáncer de mama: transformando hallazgos moleculares en herramientas clínicas" está centrada en el estudio del microRNA miR-99a-5p en cáncer de mama y en la determinación de su potencial como diana terapéutica y biomarcador para el diagnóstico de dicha enfermedad. En el primer capítulo, se lleva a cabo una revisión general del cáncer de mama y los microRNAs. A continuación, en el segundo capítulo se presentan los objetivos. En el tercer capítulo se compararon los perfiles de expresión de microRNAs de una línea celular de cáncer de mama resistente a doxorrubicina frente a la línea celular parental, dando lugar a la identificación del microRNA miR-99a-5p como el más desregulado entre ambas. A continuación, se confirmó que el miR-99a-5p aumenta la sensibilidad a doxorrubicina mediante la inhibición directa de la expresión de COX-2, que conlleva la inhibición de la expresión de la proteína ABCG2, ampliamente descrita por su papel en resistencia a fármacos. En base a los resultados obtenidos, se diseñaron nanodispositivos basados en nanopartículas mesoporosas de sílice para la liberación de miR-99a-5p y doxorrubicina en los tumores. Se confirmó la eficacia de las nanopartículas para reducir el crecimiento tumoral así como los efectos adversos asociados a la doxorrubicina libre en un modelo ortotópico murino de cáncer de mama. En el cuarto capítulo, se evaluó el potencial del miR-99a-5p como biomarcador para el diagnóstico del cáncer de mama. Se determinó la expresión del microRNA en tumores primarios de cáncer de mama y en tejidos sanos. Los resultados mostraron que el miR-99a-5p se encuentra infraexpresado en los tejidos cancerosos. A continuación, con el objeto de determinar el potencial del miR-99a-5p como biomarcador mínimamente invasivo, se determinaron los niveles de expresión en plasma de pacientes de cáncer de mama y de donantes sanos. Se encontró que el miR-99a-5p se encuentra a mayor concentración en el plasma de pacientes con cáncer de mama. Estos resultados se validaron en una cohorte independiente. Mediante el análisis en base a curvas ROC se confirmó que el miR-99a-5p es útil como biomarcador no invasivo para el diagnóstico del cáncer de mama incluso en estadíos tempranos de la enfermedad. El quinto capítulo se centra el diseño y validación de un biosensor basado en soportes de alúmina mesoporosa para la detección del miR-99a-5p en plasma. Los poros de una placa de alúmina mesoporosa se cargaron con el fluoróforo rodamina B, y se utilizaron oligonucleótidos complementarios a la secuencia del miR-99a-5p como puertas moleculares capaces de retener los fluoróforos en el interior de los poros. En presencia del miR-99a-5p, se produce liberación de rodamina B, que es posteriormente detectada ópticamente. Se confirmó la especificidad del biosensor, así como su alta sensibilidad. Además, utilizando muestras de plasma de pacientes de cáncer de mama y controles sanos, se confirmó la eficiencia del dispositivo para detectar cáncer de mama incluso en estadíos tempranos. Por último, en los capítulos cinco y seis se presentan la discusión general y las conclusiones principales extraídas. En conclusión, esta tesis doctoral demuestra que el miR-99a-5p tiene potencial como diana terapéutica y biomarcador para el cáncer de mama, y podría ser útil para mejorar el pronóstico de los pacientes con dicha enfermedad. Se ha elucidado que uno de los mecanismos por los que el miR-99a-5p está involucrado en sensibilidad a doxorrubicina es mediante la regulación del eje COX-2/ABCG2. Además, las nanopartículas diseñadas para la administración combinada de miR-99a-5p y doxorrubicina se presentan como una herramienta con gran potencial para el tratamiento oncológico. Por último, aprovechando el potencial del miR-99a-5p como biomarcador diagnóstico, se ha desarrollado un sistema de detección que podría ser una herramienta útil para mejorar la detección temprana del cáncer de mama., [CA] La present tesis doctoral, titulada "paper del miR-99a-5p en càncer de mama: transformant descobriments moleculars en eines clíniques" està centrada en l'estudi del microRNA miR-99a-5p en càncer de mama i en la determinació del seu potencial com a diana terapèutica i biomarcador per al diagnòstic d'aquesta malaltia. En el primer capítol, es du a terme una revisió general del càncer de mama i els microRNAs. A continuació, en el segon capítol es presenten els objectius. En el tercer capítol es van comparar els perfils d'expressió de microRNAs d'una línia cel·lular de càncer de mama resistent a doxorrubicina amb la seua línia parental, donant lloc a la identificació del microRNA miR-99a-5p com el més desregulat entre ambdues. A continuació, es va confirmar que el miR-99a-5p augmenta la sensibilitat al fàrmac mijançant la inhibició directa de l'expressió de COX-2 de forma directa, que comporta la inhibició de l'expressió de la proteïna ABCG2 que està àmpliament descrita pel seu paper en resistència a fàrmacs. Basant-se en els resultats obtinguts, es van dissenyar nanodispositius basats en nanopartícules mesoporoses de sílice per a l'alliberament d'una combinació de miR-99a-5p i doxorrubicina en els tumors. L'eficacia dels sistemes per a reduir el creixement tumoral així com els efectes adversos associats a la doxorrubicina lliure es va confirmar en un model ortotòpic murí de càncer de mama. En el quart capítol, es va avaluar el potencial del miR-99a-5p com a biomarcador per al diagnòstic del càncer de mama. Es va determinar l'expressió del microRNA en tumors primaris de càncer de mama i en teixits sans. Els resultats van mostrar que el miR-99a-5p es troba infraexpressat en els teixits cancerosos. A continuació, amb l'objectiu de determinar el potencial del miR-99a-5p com a biomarcador mínimament invasiu, es van determinar els nivells d'expressió en plasma de pacients de càncer de mama i de donants sans. Es va trobar que el miR-99a-5p es troba a major concentració en el plasma de pacients amb càncer de mama. Aquestos resultats es van validar en una cohort independent. Per mitjà de l'anàlisi basant-se en corbes ROC es va confirmar que el miR-99a-5p és útil com a biomarcador no invasiu per al diagnòstic del càncer de mama inclús en estadis primerencs de la malaltia. El quint capítol es centra en el disseny i validació d'un biosensor basat en suports d'alúmina nanoporosa per la detecció del miR-99a-5p en plasma. Els porus d'una placa d'alúmina es van carregar amb l'indicador fluorescent rodamina B, i es van utilitzar oligonucleòtids complementaris a la seqüència del miR-99a-5p com a portes moleculars amb la capacitat de retindre els fluoròfors a l'interior dels porus. En presència del miR-99a-5p, es produeix l'alliberament de rodamina B, que serà posteriorment detectada òpticament. Es va confirmar l'especificitat del biosensor, així com la seua alta sensibilitat. A més, utilitzant mostres de plasma de pacients de càncer de mama i controls sans, es va confirmar l'eficiència del dispositiu per a detectar càncer de mama inclús en estadis primerencs. Finalment, en els capítols sis i set es presenten la discussió general i les conclusions principals. En conclusió, aquesta tesi doctoral demostra que el miR-99a-5p té potencial com a diana terapèutica i biomarcador per al càncer de mama, i podria ser útil per a millorar el pronòstic dels pacients amb dita malaltia. S'ha elucidat que un dels mecanismes pels quals el miR-99a-5p està involucrat en sensibilitat a doxorrubicina és per mitjà de la regulació de l'eix COX-2/ABCG2. A més, les nanopartícules dissenyades per a l'administració combinada de miR-99a-5p i doxorrubicina es presenta com una ferramenta amb gran potencial per al tractament oncològic. Finalment, aprofitant el potencial del miR-99a-5p com a biomarcador diagnòstic, s'ha desenvolupat un sistema de detecció que podria ser una ferramenta útil per a millorar la detecció primerenca del càncer de mama., [EN] This PhD thesis, entitled "Role of miR-99a-5p in breast cancer: translating molecular findings into clinical tools" is focused on the study of the microRNA miR-99a-5p in breast cancer and in determining its potential as a therapeutic target and biomarker for the diagnosis of this disease. In the first chapter, a general review of breast cancer is carried out and microRNAs are also introduced. Next, in the second chapter, the objectives are detailed. In the third chapter, the microRNA expression profile of a doxorubicin-resistant breast cancer cell line was compared with its parental cell line, leading to the identification of the microRNA miR-99a-5p as the most deregulated between the two of them. Subsequently, it was confirmed that miR-99a-5p increases drug sensitivity through directly targeting COX-2, which leads to the inhibition of the expression of the ABCG2 protein, widely described to be involved in drug resistance. Based on the obtained results, nanodevices based on mesoporous silica nanoparticles were designed for the combined release of miR-99a-5p and doxorubicin in tumors. The ability of the systems to specifically target the CD44 receptor, which is overexpressed in breast cancer tumors, as well as to release the cargo specifically after internalization, were tested in vitro. Furthermore, the efficacy of the nanoparticles to reduce tumor growth and the adverse effects associated with free doxorubicin was confirmed in a murine orthotopic model of breast cancer. In the fourth chapter, the potential of miR-99a-5p as a biomarker for the diagnosis of breast cancer was evaluated. First, microRNA expression was determined in primary breast cancer tumors and compared with healthy tissues. The results showed that miR-99a-5p is downregulated in breast cancer tissues. Next, to determine the potential of the microRNA as a minimally invasive biomarker, the expression levels of miR-99a-5p in plasma of breast cancer patients and healthy donors were determined. In this case, it was found that miR-99a-5p is at higher concentrations in the plasma of breast cancer patients. These results were validated in an independent cohort. Through the ROC curve analysis, it was confirmed that miR-99a-5p is useful as a non-invasive biomarker for the diagnosis of breast cancer even at early stages. The fifth chapter focus on the design and validation of a biosensor based on nanoporous alumina supports for the detection of miR-99a-5p in plasma. The pores of the alumina plate were loaded with the fluorescent indicator rhodamine B, and oligonucleotides with a sequence complementary to the miR-99a-5p were used as molecular gates able to maintain fluorophores inside the pores. In the presence of miR-99a-5p, the capping oligonucleotide is displaced, leading to the opening of the pores and the release of rhodamine B, which is subsequently optically detected. The specificity and high sensitivity of the biosensor were confirmed. Furthermore, the efficiency of the device to detect breast cancer even at early stages was confirmed using plasma samples from breast cancer patients and healthy controls. Finally, chapters five and six present the general discussion and conclusions. In conclusion, this PhD thesis demonstrates that miR-99a-5p is a molecule with potential as a therapeutic target and biomarker for breast cancer, and it could be useful to improve the prognosis of patients. It has been elucidated that one of the mechanisms by which miR-99a-5p is involved in doxorubicin sensitivity is through the regulation of the COX-2/ABCG2 axis. Furthermore, nanoparticles designed for the combined administration of miR-99a-5p and doxorubicin are presented as a tool with great potential for cancer treatment and could be useful for the administration of microRNAs as therapy. Finally, taking advantage of the potential of miR-99a-5p as a diagnostic biomarker, a detection system has been developed and could be a useful tool to improve early detection of breast cancer., This work was supported by, CIBERONC (CB16/12/00481), CIBER-BBN (CB07/01/2012), Spanish Government PI18/01219 (ISCIII), project RTI2018- 100910-B-C41 (MCUI/AEI/FEDER, UE) and the Generalitat Valenciana (PROMETEO/2018/024) for support. IG-C was funded by Generalitat Valenciana (ACIF/2016/030). LP was funded by Ministerio de Economia, Industria y Competitividad (FPI grant). SS was funded by Instituto de Salud Carlos III and the European Social Fund for the financial support “Sara Borrell” (CD16/000237). JMC was funded by Sociedad Española de Oncología Médica (Río Hortega-SEOM. The authors would like to thank the INCLIVA Biobank (PT17/0015/0049; B.000768 ISCIII) and the Valencian Biobanking Network integrated into the Spanish National Biobanks Network for providing the human biological samples. We would also like to thank the plasma donors and the nursing staff that accepted to participate in this study.

Primary progressive aphasia (PPA) damages the parts of the brain that control speech and language. There are three clinical PPA variants: nonfluent/agrammatic (nfvPPA), logopenic (lvPPA) and semantic (svPPA). The pathophysiology underlying PPA variants is not fully understood, including the role of micro (mi)RNAs which were previously shown to play a role in several neurodegenerative diseases. Using a two-step analysis (array and validation through real-time PCR), we investigated the miRNA expression pattern in serum from 54 PPA patients and 18 controls. In the svPPA cohort, we observed a generalized upregulation of miRNAs with miR-106b-5p and miR-133a-3p reaching statistical significance (miR-106b-5p: 2.69 ± 0.89 mean ± SD vs. 1.18 ± 0.28, p < 0.0001; miR-133a-3p: 2.09 ± 0.10 vs. 0.74 ± 0.11 mean ± SD, p = 0.0002). Conversely, in lvPPA, the majority of miRNAs were downregulated. GO enrichment and KEGG pathway analyses revealed that target genes of both miRNAs are involved in pathways potentially relevant for the pathogenesis of neurodegenerative diseases. This is the first study that investigates the expression profile of circulating miRNAs in PPA variant patients. We identified a specific miRNA expression profile in svPPA that could differentiate this pathological condition from other PPA variants. Nevertheless, these preliminary results need to be confirmed in a larger independent cohort.

Diffuse midline gliomas (DMGs) originate in the thalamus, brainstem, cerebellum and spine. This entity includes tumors that infiltrate the pons, called diffuse intrinsic pontine gliomas (DIPGs), with a rapid onset and devastating neurological symptoms. Since surgical removal in DIPGs is not feasible, the purpose of this study was to profile circulating miRNA expression in DIPG patients in an effort to identify a non-invasive prognostic signature with clinical impact. Using a high-throughput platform, miRNA expression was profiled in serum samples collected at the time of MRI diagnosis and prior to radiation and/or systemic therapy from 47 patients enrolled in clinical studies, combining nimotuzumab and vinorelbine with concomitant radiation. With progression-free survival as the primary endpoint, a semi-supervised learning approach was used to identify a signature that was also tested taking overall survival as the clinical endpoint. A signature comprising 13 circulating miRNAs was identified in the training set (n = 23) as being able to stratify patients by risk of disease progression (log-rank p = 0.00014; HR = 7.99, 95% CI 2.38–26.87). When challenged in a separate validation set (n = 24), it confirmed its ability to predict progression (log-rank p = 0.00026; HR = 5.51, 95% CI 2.03–14.9). The value of our signature was also confirmed when overall survival was considered (log-rank p = 0.0021, HR = 4.12, 95% CI 1.57–10.8). We have identified and validated a prognostic marker based on the expression of 13 circulating miRNAs that can shed light on a patient’s risk of progression. This is the first demonstration of the usefulness of nucleic acids circulating in the blood as powerful, easy-to-assay molecular markers of disease status in DIPG. This study provides Class II evidence that a signature based on 13 circulating miRNAs is associated with the risk of disease progression.

Circulating miRNAs are increasingly studied and proposed as tumor markers with the aim of investigating their role in monitoring the response to therapy as well as the natural evolution of primary or secondary brain tumors. This study aimed to evaluate the modulation of the expression of three miRNAs, miR-21, miR-222 and miR-124-3p, in the serum exosomes of patients with high-grade gliomas (HGGs) and brain metastases (BMs) to verify their usefulness in the differential diagnosis of brain masses; then, it focused on their variations following the surgical and/or radiosurgical treatment of the BMs. A total of 105 patients with BMs from primary lung or breast cancer, or melanoma underwent neurosurgery or radiosurgery treatment, and 91 patients with HGGs were enrolled, along with 30 healthy controls. A significant increase in miR-21 expression in serum exosomes was observed in both HGGs and BMs compared with healthy controls; on the other hand, miR-124-3p was significantly decreased in BMs, and it was increased in HGGs. After the surgical or radiosurgical treatment of patients with BMs, a significant reduction in miR-21 was noted with both types of treatments. This study identified a signature of exosomal miRNAs that could be useful as a noninvasive complementary analysis both in the differential diagnosis of BMs from glial tumors and in providing information on tumor evolution over time.

This study aimed to explore the correlation of miR-125a with risk and severity of psoriasis, and further investigate the potential of miR-125a for predicting response to etanercept (ETN) treatment in psoriatic patients. Moderate to severe plaque psoriatic patients (n = 126) about to undergo ETN treatment for 6 months were recruited. Their plasma samples were obtained, and Psoriasis Area and Severity Index (PASI) scores and PASI-75 response rate were assessed at baseline (M0), and at 1 (M1), 3 (M3) and 6 months (M6) of treatment. Referring to PASI-75 response status at M6, patients were categorized as PASI-75 responders and PASI-75 non-responders. Healthy controls (HC, n =120) were also enrolled and their plasma samples were collected. In addition, plasma miR-125a was determined by quantitative polymerase chain reaction. miR-125a was decreased in psoriatic patients compared with HC; further, the receiver-operator curve (ROC) exhibited that miR-125a was of good value in differentiating psoriatic patients from HC with an area under the curve (AUC) of 0.802. In psoriatic patients, miR-125a was negatively associated with PASI score to some extent. Interestingly, baseline miR-125a was lower in PASI-75 responders than PASI-75 non-responders; further, ROC showed it predicted PASI-75 response at M6 to some extent with AUC of 0.672. Multivariate logistic regression also revealed that miR-125a was an independent predictive factor for worse PASI-75 response at M6. Furthermore, miR-125a expression was gradually increased during the treatment in PASI-75 responders, but unchanged in PASI-75 non-responders. Measurement of circulating miR-125a exhibits good value in the management of ETN-treated psoriatic patients.

Despite recent advances in targeted and immune therapy, 5‑year overall survival in stages III–IV of melanoma is 50 and 10–20 %, respectively. Modern melanoma biomarkers, which are used in clinical practice, are not sufficiently effective for early diagnosis and prognosis assessment. In the last decade, circulating microRNAs (miRNAs) have come to be regarded as “ideal” melanoma biomarkers. This article presents the characteristics of miRNA biogenesis, as well as provides a critical review of circulating miRNAs as promising diagnostic and prognostic melanoma biomarkers.

Background Circulating miRNAs (c-miRNAs) are found in most, if not all, biological fluids and are becoming well-established non-invasive biomarkers of many human pathologies. However, their features in non-pathological contexts and whether their expression profiles reflect normal life history events have received little attention, especially in non-mammalian species. The aim of the present study was to investigate the potential of c-miRNAs to serve as biomarkers of reproductive and metabolic states in fish. Results The blood plasma was sampled throughout the reproductive cycle of female rainbow trout subjected to two different feeding regimes that triggered contrasting metabolic states. In addition, ovarian fluid was sampled at ovulation, and all samples were subjected to small RNA-seq analysis, leading to the establishment of a comprehensive miRNA repertoire (i.e., miRNAome) and enabling subsequent comparative analyses to a panel of RNA-seq libraries from a wide variety of tissues and organs. We showed that biological fluid miRNAomes are complex and encompass a high proportion of the overall rainbow trout miRNAome. While sharing a high proportion of common miRNAs, the blood plasma and ovarian fluid miRNAomes exhibited strong fluid-specific signatures. We further revealed that the blood plasma miRNAome significantly changed depending on metabolic and reproductive states. We subsequently identified three evolutionarily conserved muscle-specific miRNAs or myomiRs (miR-1-1/2-3p, miR-133a-1/2-3p, and miR-206-3p) that accumulated in the blood plasma in response to high feeding rates, making these myomiRs strong candidate biomarkers of active myogenesis. We also identified miR-202-5p as a candidate biomarker for reproductive success that could be used to predict ovulation and/or egg quality. Conclusions Together, these promising results reveal the high potential of c-miRNAs, including evolutionarily conserved myomiRs, as physiologically relevant biomarker candidates and pave the way for the use of c-miRNAs for non-invasive phenotyping in various fish species.

Background Autism spectrum disorder is a condition related to brain development that affects a person’s perception and socialization, resulting in problems in social interaction and communication. It has no single known cause, yet several different genes appear to be involved in autism. As a genetically complex disease, dysregulation of miRNA expression and miRNA–mRNA interactions might be a feature of autism spectrum disorder. The aim of the current study was to investigate the expression profile of circulating miRNA-128, miRNA-7 and SHANK gene family in ASD patients and to assess the possible influence of miRNA-128 and miRNA-7 on SHANK genes, which might provide an insight into the pathogenic mechanisms of ASD and introduce noninvasive molecular biomarkers for the disease diagnosis and prognosis. Quantitative real-time PCR technique was employed to determine expression levels of miRNA-128, miRNA-7 and SHANK gene family in blood samples of 40 autistic cases along with 30 age- and sex-matched normal volunteer subjects. Results Our study revealed a statistical significant upregulation of miRNA-128 expression levels in ASD cases compared to controls (p value SHANK-3 expression was encountered on comparing cases to controls (p value Conclusions MiRNA-128 and SHANK-3 gene are emerging players in the field of ASD. They are promising candidates as noninvasive biomarkers in autism. Future studies are needed to emphasize their pivotal role.

Coronavirus Disease 2019 (COVID-19) pneumonia is a life-threatening infectious disease, especially for elderly patients with multiple comorbidities. Despite enormous efforts to understand its underlying etiopathogenic mechanisms, most of them remain elusive. In this study, we compared differential plasma miRNAs and cytokines profiles between COVID-19 and other community-acquired pneumonias (CAP). A first screening and subsequent validation assays in an independent cohort of patients revealed a signature of 15 dysregulated miRNAs between COVID-19 and CAP patients. Additionally, multivariate analysis displayed a combination of 4 miRNAs (miR-106b-5p, miR-221-3p, miR-25-3p and miR-30a-5p) that significantly discriminated between both pathologies. Search for targets of these miRNAs, combined with plasma protein measurements, identified a differential cytokine signature between COVID-19 and CAP that included EGFR, CXCL12 and IL-10. Significant differences were also detected in plasma levels of CXCL12, IL-17, TIMP-2 and IL-21R between mild and severe COVID-19 patients. These findings provide new insights into the etiopathological mechanisms underlying COVID-19.

We conducted a screening analysis to assess the presence of a characteristic extracellular circulating microRNAs (ci-miRNAs) profile in Behcet's syndrome (BS). Total RNA was extracted from platelets-free plasma (PFP) samples obtained from 16 BS patients and 18 healthy controls. Ci-miRNAs profiling was conducted by using dedicated Agilent microarray hybridization and data extraction technology. Statistical analysis of data extracted from microarray scanning revealed the deregulation of 36 ci-miRNAs, which turned out be differentially expressed between BS patients and healthy controls. Detailed experimental methods and data analysis were described here. The raw and normalized microarray data were deposited into Gene Expression Omnibus (GEO) under accession number {"type":"entrez-geo","attrs":{"text":"GSE145191","term_id":"145191"}}GSE145191.

Epithelial ovarian cancer (EOC) is one of the most lethal cancers worldwide, mostly due to nonspecific symptoms and a lack of screening tests, which, taken together, contribute to delayed diagnosis and treatment. The current clinical biomarker is serum CA-125, which allows the identification of most advanced primary and relapsed disease and correlates with disease burden; however, as well highlighted in the literature, CA-125 often lacks sensitivity and specificity, and is not helpful in monitoring chemotherapeutic response or in predicting the risk of relapse. Given that, the identification of novel biomarkers able to foster more precise medical approaches and the personalization of patient management represents an unmet clinical requirement. In this context, circulating miRNAs may represent an interesting opportunity as they can be easily detected in all biological fluids. This is particularly relevant when looking for non-invasive approaches that can be repeated over time, with no pain and stress for the oncological patient. Given that, the present review aims to describe the circulating miRNAs currently identified as associated with therapeutic treatments in OC and presents a complete overview of the available evidence.

Since circulating microRNAs (miRNAs) are involved in the modulation of the immune response, they are tested as liquid biopsy-based biomarkers in patients with NSCLC treated with immunotherapy. We analyzed the expression levels and examined the clinical significance of immunoregulatory miRNAs involved in immune checkpoint regulation (miR-34a, miR-200b, miR-200c), T-cell activity (miR-155), and the function of myeloid-derived suppressive cells (MDSCs) (miR-223) or regulatory T lymphocytes (Tregs) (miR-146a), in patients with advanced NSCLC (N = 69) treated with anti-PD-1 (Nivolumab) immunotherapy as 2nd or 3rd line of treatment therapy. Plasma levels of circulating miRNAs were analyzed by RT-qPCR before the initiation of immunotherapy. Expression of miR-34a, miR-146a, mir-200c, and miR-223 was found to be associated with response to immunotherapy. High miR-200c expression emerged as an independent prognostic factor for inferior overall survival in all patients with NSCLC (OS, HR: 2.243, 95% CI: 1.208–4.163; p = 0.010) and in patients with non-Squamous (non-SqCC) subtype (N = 38) (HR: 2.809, 95% CI: 1.116–7.074; p = 0.028). Low miR-34a expression independently predicted for shorter OS (HR: 3.189, 95% CI: 1.193–8.527; p = 0.021) in the non-SqCC subgroup. Our findings suggest that alterations in circulating miR-200c and miR-34a expression levels are associated with the response and outcome in patients with advanced NSCLC treated with anti-PD1 immunotherapy.