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Usefulness of circulating microRNAs miR-146a and miR-16-5p as prognostic biomarkers in community-acquired pneumonia
José María Galván-Román1,2, Ángel Lancho-Sánchez3,4, Sergio Luquero-Bueno5
1Department of Internal Medicine, University Hospital La Princesa, Madrid, Spain.
Introduction:
Patients with community-acquired pneumonia (CAP) undergo a dysregulated host response that is related to mortality. MicroRNAs (miRNAs) participate in this response, but their expression pattern and their role as biomarkers in CAP have not been fully characterized.
Methods:
A prospective observational study was performed in a cohort of 153 consecutive patients admitted to hospital with CAP. Clinical and analytical variables were collected, and the main outcome variable was 30-day mortality. Small RNA was purified from plasma of these patients obtained on the first day of admission, and miRNA expression was analyzed by RT-PCR. Univariate and multivariate analyses were carried out through the construction of a logistic regression model. The proposed model was compared with established prognostic clinical scales using ROC curve analysis.
Results:
The mean age of the patients included was 74.7 years [SD 15.9]. Their mean PSI was 100.9 [SD 34.6] and the mean modified Charlson index was 2.9 [SD 3.0]. Both miR-146a and miR-16-5p showed statistically significant association with 30-day mortality after admission due to CAP (1.10 vs. 0.23 and 51.74 vs. 35.23, respectively), and this association remained for miR-16-5p in the multivariate analysis adjusted for age, gender and history of bronchoaspiration (OR 0.95, p = 0.021). The area-under-the-curve (AUC) of our adjusted multivariate model (AUC = 0.954 95%CI [0.91-0.99]), was better than those of prognostic scales such as PSI (AUC = 0.799 [0.69-0.91]) and CURB-65 (AUC = 0.722 [0.58-0.86]).
Conclusions:
High levels of miR-146a-5p and miR-16-5p upon admission due to CAP are associated with lower mortality at 30 days of follow-up. Both miRNAs could be used as biomarkers of good prognosis in subjects hospitalized with CAP.
Insights
High levels of miR-146a-5p and miR-16-5p in patients with community-acquired pneumonia (CAP) indicate a good prognosis and lower 30-day mortality. These microRNAs show potential as biomarkers for CAP patient outcomes.
Area of Science:
- Biochemistry
- Molecular Biology
- Medical Diagnostics
Background:
- Community-acquired pneumonia (CAP) involves a dysregulated host response linked to mortality.
- MicroRNAs (miRNAs) play a role in this response, but their biomarker potential in CAP is not fully understood.
Purpose of the Study:
- To investigate the expression patterns of specific miRNAs in CAP patients.
- To evaluate the association of miRNA expression with 30-day mortality.
- To assess the utility of miRNAs as prognostic biomarkers in CAP.
Main Methods:
- A prospective observational study of 153 hospitalized CAP patients.
- Plasma miRNA expression analyzed by RT-PCR on admission.
- Univariate and multivariate logistic regression, and ROC curve analysis compared to established scales (PSI, CURB-65).
Main Results:
- miR-146a-5p and miR-16-5p levels were significantly associated with 30-day mortality.
- miR-16-5p remained a significant predictor in multivariate analysis (OR 0.95, p=0.021).
- The developed miRNA-based model (AUC=0.954) outperformed PSI (AUC=0.799) and CURB-65 (AUC=0.722).
Conclusions:
- Elevated miR-146a-5p and miR-16-5p upon admission correlate with reduced 30-day mortality in CAP.
- These miRNAs show promise as biomarkers for predicting good prognosis in hospitalized CAP patients.
