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目的:分析miR-23a在系统性红斑狼疮(SLE)患者血浆中的表达及临床意义。方法:收集54例SLE患者、16例类风湿性关节炎(RA)患者和20例健康对照血浆标本,抽提血浆小RNA,反转录后,以celmiR-39为外参,通过定量PCR检测血浆miR-23a的表达,统计分析miR-23a表达水平与临床资料的相关性。结果:miR-23a在SLE患者、健康对照和RA患者血浆中的相对表达量差异具有统计学意义(x~2=39.199,P<0.001)。与RA患者及健康对照比较,SLE患者血浆中miR-23a表达水平明显下调(P<0.05)。受试者工作特征曲线(ROC曲线)分析显示,血浆miR-23a区分SLE患者和健康对照以及RA患者的ROC曲线下面积(AUC)分别为0.931和0.884。血浆miR-23a表达水平以19.22临界值区分SLE患者和健康对照的特异性和敏感性达74.5%和88.9%;以30.98临界值区分SLE与RA患者的特异性和敏感性达73.3%和86.3%。血浆miR-23a的表达水平与SLE临床检测指标的相关性分析显示,血浆miR-23a的表达水平与抗核抗体(ANA)滴度水平及血白细胞计数(P<0.05)相关。结论:SLE患者血浆中下调表达的miR-23a可能与其发病和病情进展相关,是SLE临床诊断一个新的生物学指标。
Objective: To analyze the expression of miR-23a in the plasma of patients with systemic lupus erythematosus (SLE) and its clinical significance. Methods: Fifty-four patients with SLE, 16 patients with rheumatoid arthritis (RA) and 20 healthy controls were enrolled in this study. Small plasma RNA was extracted. After reverse transcription, celmiR-39 was used as a reference substance and detected by quantitative PCR Plasma miR-23a expression, statistical analysis of miR-23a expression levels and clinical data relevance. Results: The relative expression of miR-23a in patients with SLE, healthy controls and RA patients was statistically significant (x ~ 2 = 39.199, P <0.001). Compared with RA patients and healthy controls, miR-23a expression was significantly down-regulated in SLE patients (P <0.05). Receiver operating characteristic curves (ROC curves) analysis showed that the area under the ROC curve (AUC) for plasma miR-23a-differentiated SLE patients and healthy controls and RA patients were 0.931 and 0.884, respectively. The specificity and sensitivity of plasma miR-23a expression levels were 74.5% and 88.9% respectively in patients with SLE and healthy controls at a cut-off value of 19.22. The specificity and sensitivity of the cutoff value of 30.98 in patients with SLE and RA were 73.3% and 86.3% . Correlation analysis between plasma miR-23a levels and clinical manifestations of SLE showed that plasma miR-23a expression level correlated with the level of antinuclear antibody (ANA) titer and white blood cell count (P <0.05). Conclusion: The down-regulated expression of miR-23a in SLE patients may be related to the pathogenesis and progression of SLE. It is a new biological indicator for the clinical diagnosis of SLE.