Clinical pathology and Molecular Genomics Unit, Medical Ain Shams Research Institute (MASRI), Faculty of Medicine, Ain Shams University, Cairo 11382, Egypt.
Cardiovascular Medicine Department, Faculty of Medicine, Ain Shams University, Cairo 1382, Egypt.
Int J Biochem Cell Biol. 2024 Apr;169:106531. doi: 10.1016/j.biocel.2024.106531. Epub 2024 Jan 26.
Acute Coronary Syndrome (ACS) stands as a significant contributor to cardiovascular mortality, necessitating improved diagnostic tools for early detection and tailored therapeutic interventions. Current diagnostic modalities, exhibit limitations in sensitivity and specificity, urging the quest for novel biomarkers to enhance discrimination of the different stages of ACS including unstable angina, Non-ST-segment Elevation Myocardial Infarction (NSTEMI), and ST-segment Elevation Myocardial Infarction (STEMI).
This study investigated the potential of a plasma-circulating multi-noncoding RNA (ncRNA) panel, comprising four miRNAs (miR-182-5p, miR-23a-3p, miR-146a-5p, and miR-183-5p) and three lncRNAs (SNHG15, SNHG5, and RMRP), selected based on their intricate involvement in ACS pathogenesis and signaling pathways regulating post-myocardial infarction (MI) processes. The differential expression of these ncRNAs was validated in sera of ACS patients and healthy controls via real-time polymerase chain reaction (RT-PCR).
Analysis revealed a marked upregulation of the multi-ncRNAs panel in ACS patients. Notably, miRNA-182-5p and lncRNA-RMRP exhibited exceptional discriminatory power, indicated by the high area under the curve (AUC) values (0.990 and 0.980, respectively). Importantly, this panel displayed superior efficacy in discriminating between STEMI and NSTEMI, outperforming conventional biomarkers like creatine kinase-MB and cardiac troponins. Additionally, the four miRNAs and lncRNA RMRP showcased remarkable proficiency in distinguishing between STEMI and unstable angina.
The findings underscore the promising potential of the multi-ncRNA panel as a robust tool for early ACS detection, and precise differentiation among ACS subtypes, and as a potential therapeutic target.
急性冠状动脉综合征（ACS）是心血管死亡率的主要原因，需要改进诊断工具以实现早期检测和针对性的治疗干预。目前的诊断方法在灵敏度和特异性方面存在局限性，因此需要寻找新的生物标志物来提高对 ACS 不同阶段（包括不稳定型心绞痛、非 ST 段抬高型心肌梗死（NSTEMI）和 ST 段抬高型心肌梗死（STEMI））的区分能力。
本研究探讨了一种血浆循环多非编码 RNA（ncRNA）谱的潜力，该谱由四个 miRNA（miR-182-5p、miR-23a-3p、miR-146a-5p 和 miR-183-5p）和三个 lncRNA（SNHG15、SNHG5 和 RMRP）组成，这些 ncRNA 是基于它们在 ACS 发病机制和调节心肌梗死后过程的信号通路中的复杂作用而选择的。通过实时聚合酶链反应（RT-PCR）验证了这些 ncRNA 在 ACS 患者和健康对照者血清中的差异表达。
分析显示 ACS 患者的多 ncRNA 谱明显上调。值得注意的是，miRNA-182-5p 和 lncRNA-RMRP 表现出卓越的区分能力，曲线下面积（AUC）值较高（分别为 0.990 和 0.980）。重要的是，该谱在区分 STEMI 和 NSTEMI 方面表现出更好的效果，优于肌酸激酶-MB 和心脏肌钙蛋白等传统生物标志物。此外，这四个 miRNA 和 lncRNA RMRP 还能很好地区分 STEMI 和不稳定型心绞痛。
这些发现强调了多 ncRNA 谱作为 ACS 早期检测、ACS 亚型精确区分以及潜在治疗靶点的强大工具的有前途的潜力。
