Pattnaik Bijay, Pb Sryma, Bhatraju Naveen, Mittal Saurabh, Arava Sudheer, Jain Deepali, Nayak Baibaswata, Tiwari Pavan, Hadda Vijay, Mohan Anant, Agrawal Anurag, Guleria Randeep, Madan Karan
Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
Trivedi School of Biosciences, Ashoka University, Sonipat, India.
ERJ Open Res. 2024 Sep 30;10(5). doi: 10.1183/23120541.00078-2024. eCollection 2024 Sep.
Sarcoidosis and tuberculosis (TB) are the two most common causes of granulomatous mediastinal lymphadenopathy. These often exhibit overlapping clinical and radiological characteristics, rendering accurate diagnosis difficult. MicroRNA (miRNA) analysis is increasingly utilised as a potential biomarker for various diseases. Exhaled breath condensate (EBC) is a noninvasive technique for biomarker evaluation in different respiratory conditions. We attempted to identify differentially expressed miRNAs in the EBC of sarcoidosis and mediastinal TB patients.
EBC was obtained from subjects with a definitive diagnosis of sarcoidosis and mediastinal TB. EBC was also obtained from age- and sex-matched control subjects. From EBC, miRNA isolation, cDNA preparation and qPCR array were performed. Differentially expressed miRNAs were shortlisted. Further validation was conducted in the EBC of a new subset.
Subjects with a definitive diagnosis of sarcoidosis (50) and TB (50), and control subjects (50) were included. qPCR array from EBC (20 subjects from each group) shortlisted eight differentially expressed miRNAs (miR-126, miR-132, miR-139-3p, miR-139-5p, miR-181c, miR-454, miR-512-3p and miR-362-5p). In the validation set (EBC of 30 subjects from each group), miR-126 and miR-132 were differentially expressed significantly. The miR-126 and miR-132 expression ratio could differentiate sarcoidosis from mediastinal TB with an AUC of 0.618 (82% specificity and 41% sensitivity).
While EBC miRNA expression is significantly and differently altered in sarcoidosis and mediastinal TB, a simple ratiometric approach failed to provide clinically useful signatures for differentiating between the two in patients with mediastinal lymphadenopathy.
结节病和结核病（TB）是肉芽肿性纵隔淋巴结肿大的两种最常见病因。它们常常表现出重叠的临床和放射学特征，使得准确诊断变得困难。微小RNA（miRNA）分析越来越多地被用作各种疾病的潜在生物标志物。呼出气冷凝物（EBC）是一种用于在不同呼吸状况下评估生物标志物的非侵入性技术。我们试图鉴定结节病和纵隔结核患者EBC中差异表达的miRNA。
从明确诊断为结节病和纵隔结核的受试者中获取EBC。也从年龄和性别匹配的对照受试者中获取EBC。从EBC中进行miRNA分离、cDNA制备和qPCR阵列分析。筛选出差异表达的miRNA。在一个新的亚组的EBC中进行进一步验证。
纳入了明确诊断为结节病的受试者（50例）、结核病患者（50例）和对照受试者（50例）。对EBC（每组20名受试者）进行qPCR阵列分析，筛选出8种差异表达的miRNA（miR-126、miR-132、miR-139-3p、miR-139-5p、miR-181c、miR-454、miR-512-3p和miR-362-5p）。在验证组（每组30名受试者的EBC）中，miR-126和miR-132有显著差异表达。miR-126和miR-132的表达比值能够区分结节病和纵隔结核，曲线下面积为0.618（特异性82%，敏感性41%）。
虽然结节病和纵隔结核患者的EBC miRNA表达有显著且不同的改变，但一种简单的比值法未能为纵隔淋巴结肿大患者区分这两种疾病提供临床上有用的特征。
