Department of Anesthesiology, Critical Care and Pain Medicine, Cardiac Anesthesia Division, Boston Children's Hospital, Boston, MA 02115, USA.
Departments of Immunology and Anaesthesia, Harvard Medical School, Boston, MA 02115, USA.
Cells. 2024 Aug 25;13(17):1417. doi: 10.3390/cells13171417.
Breakthroughs in surgical and medical techniques have significantly improved outcomes for children with congenital heart disease (CHD), but research continues to address the ongoing challenge of organ dysfunction after surgery, particularly in neonates and infants. Our study explored circular RNAs (circRNAs) within plasma-derived extracellular vesicles (EVs) in neonates and infants undergoing CHD surgery. Post-surgery EV circRNAs showed dramatic expression changes between organ dysfunction (OD) and control groups. Tissue injury-related pathways were consistent across pre- and post-surgery in OD. The top two significant predicted tissue sources of these circRNAs originated from the respiratory system, aligning with the fact that all patients in the OD arm experienced respiratory dysfunction. Five of these circRNAs, namely circ-CELSR1, circ-PLXNA1, circ-OBSL1, circ-DAB2IP, and circ-KANK1, significantly correlated with PELOD (Pediatric Logistic Organ Dysfunction) score and demonstrated high performance (AUC = 0.95), supporting the potential of circRNAs as prognostic markers. These findings pave the way for EV circRNAs as promising tools for managing post-surgical organ dysfunction and potentially guiding therapeutic strategies in children with CHD.
手术和医疗技术的突破显著改善了先天性心脏病（CHD）患儿的预后，但研究仍在继续解决手术后器官功能障碍的持续挑战，特别是在新生儿和婴儿中。我们的研究探讨了接受 CHD 手术的新生儿和婴儿血浆衍生的细胞外囊泡（EV）中的环状 RNA（circRNA）。手术后 EV circRNA 在器官功能障碍（OD）和对照组之间表现出明显的表达变化。OD 中组织损伤相关途径在手术前后是一致的。这些 circRNA 两个最显著的预测组织来源都来自呼吸系统，与 OD 组中的所有患者都经历了呼吸功能障碍的事实一致。其中 5 个 circRNA，即 circ-CELSR1、circ-PLXNA1、circ-OBSL1、circ-DAB2IP 和 circ-KANK1，与 PELOD（儿科逻辑器官功能障碍）评分显著相关，表现出高性能（AUC=0.95），支持 circRNA 作为预后标志物的潜力。这些发现为 EV circRNA 作为管理手术后器官功能障碍的有前途的工具铺平了道路，并有可能指导 CHD 儿童的治疗策略。
