Jabandziev Petr, Kakisaka Tatsuhiko, Bohosova Julia, Pinkasova Tereza, Kunovsky Lumir, Slaby Ondrej, Goel Ajay
Department of Pediatrics, University Hospital Brno, Faculty of Medicine, Masaryk University, 613 00 Brno, Czech Republic.
Central European Institute of Technology, Masaryk University, 625 00 Brno, Czech Republic.
J Clin Med. 2021 Mar 23;10(6):1325. doi: 10.3390/jcm10061325.
Prevalence of inflammatory bowel disease has been on the rise in recent years, especially in pediatric populations. This study aimed to provide precise identification and stratification of pediatric patients with diagnosed ulcerative colitis (UC) according to the severity of their condition and the prediction for standard treatment according to the specific expression of candidate miRNAs. We enrolled consecutive, therapeutically naïve, pediatric UC patients with confirmed pancolitis. We examined formalin-fixed paraffin-embedded specimens of colonic tissue for the expression of 10 selected candidate miRNAs. We performed receiver operating characteristic curve analysis, using area under the curve and a logistic regression model to evaluate the diagnostic and predictive power of the miRNA panels. Sixty patients were included in the final analysis. As a control group, 18 children without macroscopic and microscopic signs of inflammatory bowel disease were examined. The combination of three candidate miRNAs (let-7i-5p, miR-223-3p and miR-4284) enabled accurate detection of pediatric UC patients and controls. A panel of four candidate miRNAs (miR-375-3p, miR-146a-5p, miR-223-3p and miR-200b-3p) was associated with severity of UC in pediatric patients and a combination of three miRNAs (miR-21-5p, miR-192-5p and miR-194-5p) was associated with early relapse of the disease. Nine patients out of the total were diagnosed with primary sclerosing cholangitis (PSC) simultaneously with ulcerative colitis. A panel of 6 candidate miRNAs (miR-142-3p, miR-146a-5p, miR-223-3p, let-7i-5p, miR-192-5p and miR-194-5p) identified those patients with PSC. Specific combinations of miRNAs are promising tools for potential use in precise disease identification and severity and prognostic stratification in pediatric patients with ulcerative pancolitis.
近年来，炎症性肠病的患病率一直在上升，尤其是在儿科人群中。本研究旨在根据病情严重程度对确诊为溃疡性结肠炎（UC）的儿科患者进行精确识别和分层，并根据候选miRNA的特定表达预测标准治疗方案。我们纳入了连续的、未经治疗的、确诊为全结肠炎的儿科UC患者。我们检查了结肠组织的福尔马林固定石蜡包埋标本中10种选定候选miRNA的表达。我们进行了受试者工作特征曲线分析，使用曲线下面积和逻辑回归模型来评估miRNA面板的诊断和预测能力。最终分析纳入了60名患者。作为对照组，检查了18名无炎症性肠病宏观和微观体征的儿童。三种候选miRNA（let-7i-5p、miR-223-3p和miR-4284）的组合能够准确检测儿科UC患者和对照组。一组四种候选miRNA（miR-375-3p、miR-146a-5p、miR-223-3p和miR-200b-3p）与儿科患者UC的严重程度相关，三种miRNA（miR-21-5p、miR-192-5p和miR-194-5p）的组合与疾病的早期复发相关。总共有9名患者在诊断为溃疡性结肠炎的同时被诊断为原发性硬化性胆管炎（PSC）。一组6种候选miRNA（miR-142-3p、miR-146a-5p、miR-223-3p、let-7i-5p、miR-192-5p和miR-194-5p）识别出了那些患有PSC的患者。miRNA的特定组合是有前景的工具，可用于精确识别疾病以及对患有全结肠炎的儿科患者进行严重程度和预后分层。
