Brown Naomi, Roman Marius, Miller Douglas, Murphy Gavin, Woźniak Marcin J
Department of Cardiovascular Sciences and NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, University of Leicester, Leicester LE3 9QP, UK.
Biomedicines. 2024 Jul 30;12(8):1695. doi: 10.3390/biomedicines12081695.
Acute kidney injury (AKI) affects 10-15% of hospitalised patients and arises after severe infections, major surgeries, or exposure to nephrotoxic drugs. AKI diagnosis based on creatinine level changes lacks specificity and may be delayed. MicroRNAs are short non-coding RNA secreted by all cells. This review of studies measuring miRNAs in AKI aimed to verify miRNAs as diagnostic markers. The study included data from patients diagnosed with AKI due to sepsis, ischaemia, nephrotoxins, radiocontrast, shock, trauma, and cardiopulmonary bypass. Out of 71 studies, the majority focused on AKI in sepsis patients, followed by cardiac surgery patients, ICU patients, and individuals receiving nephrotoxic agents or experiencing ischaemia. Studies that used untargeted assays found 856 differentially regulated miRNAs, although none of these were confirmed by more than one study. Moreover, 68 studies measured miRNAs by qRT-PCR, and 2 studies reported downregulation of miR-495-3p and miR-370-3p in AKI patients with sepsis after the AKI diagnosis. In three studies, upregulation of miR-21 was reported at the time of the AKI diagnosis with a significant pooled effect of 0.56. MiR-21 was also measured 19-24 h after cardiac surgery in three studies. However, the pooled effect was not significant. Despite the considerable research into miRNA in AKI, there is a knowledge gap in their applicability as diagnostic markers of AKI in humans.
急性肾损伤（AKI）影响10%至15%的住院患者，在严重感染、大手术后或接触肾毒性药物后发生。基于肌酐水平变化的AKI诊断缺乏特异性，且可能延迟。微小RNA是所有细胞分泌的短链非编码RNA。本项对测量AKI中微小RNA的研究进行的综述旨在验证微小RNA作为诊断标志物。该研究纳入了因脓毒症、缺血、肾毒素、放射造影剂、休克、创伤和体外循环而被诊断为AKI的患者的数据。在71项研究中，大多数聚焦于脓毒症患者的AKI，其次是心脏手术患者、重症监护病房患者以及接受肾毒性药物或经历缺血的个体。使用非靶向检测方法的研究发现了856种差异调节的微小RNA，不过这些均未被超过一项研究所证实。此外，68项研究通过定量逆转录聚合酶链反应（qRT-PCR）测量微小RNA，2项研究报告称在脓毒症AKI患者确诊后，miR-495-3p和miR-370-3p表达下调。在三项研究中，报告称在AKI确诊时miR-21表达上调，合并效应显著，为0.56。在三项研究中还在心脏手术后19至24小时测量了miR-21。然而，合并效应不显著。尽管对AKI中的微小RNA进行了大量研究，但在其作为人类AKI诊断标志物的适用性方面仍存在知识空白。
