Department of Neurology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China.
Department of Neurology, Ruijin Hospital Luwan Branch, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200020, China.
J Psychiatr Res. 2019 Aug;115:129-141. doi: 10.1016/j.jpsychires.2019.05.018. Epub 2019 May 17.
We aimed to explore the circulating microRNAs biomarkers in the acute stage following cerebral ischemia to earlier warn late-onset post-stroke depression (PSD). A total of 251 consecutive patients with acute ischemic stroke were recruited. They were divided into three groups depending on whether PSD had occurred at 2 weeks or 3 months since stroke: early-onset PSD, late-onset PSD, and non-depressed group. Microarray assay was conducted to identify the different expression profiles of plasma miRNAs. Comprehensive bioinformatics analysis for their integrating putative target genes was performed. The key miRNA was validated in a larger cohort and its function was further studied in ischemic mice brain. We screened three differentially expressed miRNAs in the late-onset PSD individuals, miR-140-5p and miR-221-3p were significantly upregulated while miR-1246 was downregulated. The bioinformatics analysis demonstrated that their predicted target genes were mainly enriched in axon development and Ras signaling pathway. Logistic regression analysis revealed that miR-140-5p was an independent risk factor for late-onset PSD (P = 0.017, OR = 2.313, 95%CI 1.158 to 4.617). The miR-140-5p expression on admission was significantly positively correlated with HDRS scores assessed at 3 months after stroke (P = 0.0007). The predictive value of miR-140-5p for late-onset PSD is 83.3% sensitivity and 72.6% specificity (AUC = 0.8127, P < 0.0001). AAV-mediated overexpression of miR-140-5p decreased the protein level of IL1rap, IL1rapl1, VEGF, and MEGF10 in the ischemic mouse hippocampus and inhibited neurogenesis and capillary density. MiR-140-5p might be involved in the pathogenesis of late-onset PSD and used as a novel early warning biomarker.
我们旨在探索脑缺血后急性期循环 microRNAs 生物标志物,以更早预警迟发性卒中后抑郁(PSD)。共纳入 251 例连续急性缺血性脑卒中患者。根据卒中后 2 周或 3 个月是否发生 PSD 将其分为三组:早发性 PSD、迟发性 PSD 和非抑郁组。采用微阵列分析鉴定血浆 miRNA 的不同表达谱。对其整合的潜在靶基因进行综合生物信息学分析。在更大的队列中验证关键 miRNA,并在缺血性小鼠脑中进一步研究其功能。我们筛选了迟发性 PSD 个体中三种差异表达的 miRNA,miR-140-5p 和 miR-221-3p 明显上调,而 miR-1246 下调。生物信息学分析表明,它们的预测靶基因主要富集在轴突发育和 Ras 信号通路中。Logistic 回归分析显示,miR-140-5p 是迟发性 PSD 的独立危险因素(P=0.017,OR=2.313,95%CI 1.158 至 4.617)。入院时 miR-140-5p 的表达与卒中后 3 个月时 HDRS 评分呈显著正相关(P=0.0007)。miR-140-5p 对迟发性 PSD 的预测价值为 83.3%的灵敏度和 72.6%的特异性(AUC=0.8127,P<0.0001)。AAV 介导的 miR-140-5p 过表达降低了缺血性小鼠海马体中 IL1rap、IL1rapl1、VEGF 和 MEGF10 的蛋白水平,并抑制了神经发生和毛细血管密度。miR-140-5p 可能参与了迟发性 PSD 的发病机制,并可用作新型早期预警生物标志物。