血小板微小RNA作为P2Y抑制剂抗血小板治疗潜在的新型生物标志物及其与血小板功能的关联

Platelet microRNAs as Potential Novel Biomarkers for Antiplatelet Therapy with P2Y Inhibitors and Their Association with Platelet Function.

作者信息

Gumiężna Karolina, Bednarek Adrian, Sygitowicz Grażyna, Maciejak-Jastrzębska Agata, Baruś Piotr, Hunia Jaromir, Klimczak-Tomaniak Dominika, Kochman Janusz, Grabowski Marcin, Tomaniak Mariusz

机构信息

First Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland.

Department of Clinical Chemistry and Laboratory Diagnostics, Medical University of Warsaw, 02-097 Warsaw, Poland.

出版信息

J Clin Med. 2023 Dec 22;13(1):63. doi: 10.3390/jcm13010063.

DOI:10.3390/jcm13010063

PMID:38202070

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10780110/

Abstract

INTRODUCTION

Patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI) require dual antiplatelet therapy (DAPT). However, the response to treatment can vary considerably. Certain platelet microRNAs (miRs) are suspected to predict DAPT response and influence platelet function. This study aimed to analyze selected miRs' expressions and compare them among patients treated with different P2Y inhibitors while assessing their association with platelet activity and turnover parameters.

MATERIALS AND METHODS

We recruited 79 ACS patients post-PCI treated with clopidogrel, ticagrelor, or prasugrel, along with 18 healthy volunteers. Expression levels of miR-126-3p, miR223-3p, miR-21-5p, miR-197-3p, and miR-24-3p, as well as immature platelet fraction (IPF) and ADP-induced platelet reactivity, were measured and compared between groups.

RESULTS

Analyses revealed significantly lower expressions of miR-126-3p, miR-223-3p, miR-21-5p, and miR-197-3p in patients treated with ticagrelor, compared to clopidogrel (fold changes from -1.43 to -1.27, -values from 0.028 to 0.048). Positive correlations were observed between platelet function and the expressions of miR-223-3p (r = 0.400, = 0.019) and miR-21-5p (r = 0.423, = 0.013) in patients treated with potent drugs. Additionally, miR-24-3p (r = 0.411, = 0.012) and miR-197-3p (r = 0.333, = 0.044) showed correlations with IPF.

CONCLUSIONS

The identified platelet miRs hold potential as biomarkers for antiplatelet therapy. (ClinicalTrials.gov number, NCT06177587).

摘要

引言

接受经皮冠状动脉介入治疗（PCI）的急性冠状动脉综合征（ACS）患者需要双重抗血小板治疗（DAPT）。然而，治疗反应可能有很大差异。某些血小板微小RNA（miR）被怀疑可预测DAPT反应并影响血小板功能。本研究旨在分析选定miR的表达，并在评估其与血小板活性和周转参数的关联时，比较接受不同P2Y抑制剂治疗的患者之间的miR表达。

材料与方法

我们招募了79例PCI术后接受氯吡格雷、替格瑞洛或普拉格雷治疗的ACS患者，以及18名健康志愿者。测量并比较了miR-126-3p、miR223-3p、miR-21-5p、miR-197-3p和miR-24-3p的表达水平，以及未成熟血小板分数（IPF）和ADP诱导的血小板反应性，并在组间进行了比较。

结果

分析显示，与氯吡格雷相比，接受替格瑞洛治疗的患者中miR-126-3p、miR-223-3p、miR-21-5p和miR-197-3p的表达显著降低（倍数变化从-1.43至-1.27，P值从0.028至0.048）。在接受强效药物治疗的患者中，观察到血小板功能与miR-223-3p（r = 0.400，P = 0.019）和miR-21-5p（r = 0.423，P = 0.013）的表达之间存在正相关。此外，miR-24-3p（r = 0.411，P = 0.012）和miR-197-3p（r = 0.333，P = 0.044）与IPF相关。