Circulating miR-181a-5p as a new biomarker for acute cellular rejection in heart transplantation
Section snippets
Study design
This prospective, observational, single-center study included patients who underwent HTx between April 2013 and August 2018 in the Complexo Hospitalario Universitario A Coruña (A Coruña, Spain). The EMB protocol to monitor rejection was every 10 to 15 days in the first 2 months, every 20 days in Months 3 and 4, and monthly in Months 5 and 6. After the sixth month, in stable patients and without any episode of treated rejection, the next EMB was at 12 months; in those patients who had an episode
Study population
A total of 121 patients were included in the study and their primary heart diseases were dilated cardiomyopathy (n = 45; 37%), ischemic cardiomyopathy (n = 44; 36%), hypertrophic cardiomyopathy (n = 13; 11%), congenital cardiomyopathy (n = 6; 5%), valvular cardiomyopathy (n = 5; 4%), and others (n = 8; 7%). The median age of the recipients was 59 (interquartile range [IQR]: 49-65) years and 82% of them were males. After excluding 4 patients (perioperative death), a total of 1,113 EMBs were
Discussion
MicroRNAs have been postulated as new potential non-invasive biomarker candidates for heart transplant rejection.12, 13, 14, 15, 16, 17, 18 In this study, after evaluating 179 serum microRNAs in the initial discovery phase, the circulating miR-181a-5p showed a rise and fall pattern that make it a potential non-invasive biomarker to detect ACR in HTx. These results were confirmed in the discovery phased using a new cohort of patients with ACR and where miR-181a-5p was found to be overexpressed
Conclusions
miR-185a-5p in serum is a candidate as a non-invasive ACR biomarker with an AUC of 0.80 and an NPV of 98%. Thus, this biomarker could reduce the need for EMBs and the associated risks and costs of this invasive procedure.
Disclosure statement
The authors have no conflicts of interest to disclose.
This study received financial support from Instituto de Salud Carlos III (PI15/02224), is part of the research activities of the Centro de investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), and was cofinanced with FEDER Funds.
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These authors have contributed equally to this work.