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Is there a role for microRNAs in epilepsy diagnostics?
Sebastian Bauer1,2, Vanessa Schütz1,2, Adam Strzelczyk1,2
1Department. Of Neurology, Epilepsy Center Frankfurt Rhine-Main, University Hospital Frankfurt, Goethe-University Frankfurt Am Main , Germany.
Introduction:
Epilepsy is a disease group that encompasses numerous brain pathologies, all leading to spontaneous seizures. Several diagnostic needs in the area of epilepsy diagnostics remain unmet. MicroRNAs (miRNAs) have emerged as potential biomarkers of disease.
Areas Covered:
We review clinical trials in epilepsy patients that investigated circulating miRNAs (CmiRNAs) as diagnostic biomarkers.
Expert Opinion:
The surveyed trial results are highly discordant and do not confidently support the identification of definite diagnostic biomarkers yet. Important progress comes from studies that identified measures to increase the discriminatory power of CmiRNAs, such as an investigation of specific miRNA compartments (e.g. exosomal vs. Argonaute-bound) or a study that developed point-of-care detection devices for CmiRNAs. No sufficient data elucidating the validity of CmiRNAs as biomarkers for monitoring disease status, the responses to treatment, the likelihood of treatment effects, prognosis, or safety or susceptibility are available. Further studies should adopt standardized designs and in-depth phenotyping to improve their validity. One of the most important and promising future research topics will be the identification of biomarkers for epileptogenesis in humans.
Insights
Circulating microRNAs (CmiRNAs) show promise as epilepsy biomarkers, but current clinical trial data is inconsistent. Further research with standardized methods is needed to validate CmiRNAs for epilepsy diagnosis and management.
Area of Science:
- Neurology
- Biomarker Discovery
- Molecular Diagnostics
Background:
- Epilepsy comprises diverse brain pathologies causing seizures, with unmet diagnostic needs.
- MicroRNAs (miRNAs) are emerging as potential disease biomarkers.
- Circulating miRNAs (CmiRNAs) are being investigated for epilepsy diagnostics.
Purpose of the Study:
- To review clinical trials on CmiRNAs as diagnostic biomarkers in epilepsy patients.
- To assess the current state of CmiRNA biomarker validation for epilepsy.
Main Methods:
- Systematic review of clinical trials investigating CmiRNAs in epilepsy.
- Analysis of study designs, results, and limitations.
Main Results:
- Clinical trial results for CmiRNAs in epilepsy are discordant, lacking definitive diagnostic biomarkers.
- Progress includes refining CmiRNA analysis (e.g., exosomal, Argonaute-bound) and developing point-of-care devices.
- Insufficient data exists for CmiRNAs in monitoring disease status, treatment response, prognosis, or safety.
Conclusions:
- Current CmiRNA data is insufficient to establish them as reliable epilepsy biomarkers.
- Standardized study designs and in-depth phenotyping are crucial for future validity.
- Identifying biomarkers for epileptogenesis in humans is a key future research direction.
