MICRORNA UTILITY FOR DIAGNOSING ISCHEMIC STROKE IN EGYPTIAN PATIENTS
Abstract
Stroke is a major public health concern in Egypt with a high overall prevalence rate and a significant impact on mortality. The identification of genetic and molecular factors involved in the development of ischemic stroke (IS) can lead to the identification of new diagnostic and therapeutic targets and the development of personalized medicine approaches for the prevention and treatment of this debilitating disease. MicroRNAs (miR-NAs) could regulate cell proliferation and apoptosis and accumulating published data have showed a correlation of miRNA with stroke pathogenesis. This work aimed to evaluate the expression level of three brain-specific miRNAs in serum: miR-9, miR-15a and miR-16 as a panel, among newly diagnosed IS-Egyptian patients compared to apparently healthy control subjects and to examine its use as diagnostic molecular biomarker for this silent disease. Serum expression level of the tested miRNA panel was detected in all subjects using quantitative real-time polymerase chain reaction (qRT-PCR). The expression levels of the investigated miR-9, miR-15a, and miR-16 had shown to be significantly (P<0.001) increased by 12.85, 5.15, and 5.89-fold change (FC), respectively in IS sera than the control group. Diabetes mellites (DM), hypertension, and NIHSS scoring of the stroke was found to have significant implication on the expression level of miR-9. DM and smoking had significant implications on the expression level of miR-15a. miR-16a had significant correlation to total cholesterol and LDL. Diagnostic potentiality of this panel for IS was tested by performing receiver operating characteristic (ROC) curve analysis, which revealed specificity for the newly tested miRNAs ranging from 95.5% to 99%, with a sensitivity between 71.56% and 82.11%. Finally, we concluded that miR-9, miR-15a, and miR- 16 may play a crucial role in ischemic injury, suggesting their promising role as molecular biomarkers for early diagnosis of IS. Additional studies are recommended on larger IS cohort compared to risky subjects to confirm the role of this panel in this context.
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