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Updated: Nov 26, 2025
Digital PCR for Quantifying Circulating MicroRNAs in Acute Myocardial Infarction and Cardiovascular Disease
Published on: July 3, 2018
Accuracy of circulating microRNAs in diagnosis of sepsis: a systematic review and meta-analysis
Xiaomin Shen1, Jiajie Zhang2, Yicheng Huang2
1State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Zhejiang Provincial Key Laboratory for Drug Clinical Research and Evaluation, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Objectives:
The aim of this study was to systematically assess the accuracy of circulating microRNAs (miRNAs) as a promising biomarker for sepsis via a meta-analysis.
Methods:
PubMed, Cochrane Library, Embase, Web of Science, Scopus, and Ovid databases were searched up to April 3, 2020. The Quality in Prognostic Studies (QUADAS-2) tool was used to assess methodological quality. The pooled sensitivity (Sen), specificity (Spe), positive or negative likelihood ratios (PLR or NLR), diagnostic odds ratio (DOR), curve, and area under the curve (AUC) were calculated with 95% confidence interval (95% CI). The overall accuracy (OA) of miRNAs, procalcitonin (PCT), and C-reactive protein (CRP) was analyzed by the chi-square test.
Results:
A total of 22 records were eligible for systematic review, including 2210 sepsis, 426 systemic inflammatory response syndrome (SIRS), and 1076 healthy controls (HC). The pooled Sen, Spe, and DOR of miRNAs were 0.80 (95% CI 0.75-0.83), 0.85 (95% CI 0.80-0.89), and 22 (15-32), respectively. The DOR of PCT and CRP were 17 (95% CI 4-68) and 7 (95% CI 1-48), respectively. The OA value of miRNAs (79.02%) and PCT (76.95%) were higher than CRP (61.22%) (P < 0.000). The subgroup analysis indicated that miRNAs in adults, serum type, downregulation of miRNA expression, criteria of Sepsis-3, internal reference of non-U6, and dysregulation expression of miR-223 had superior diagnostic accuracy. In addition, there was no significant publication bias among the included studies. Fagan's nomogram showed valuable clinical utility.
Conclusions:
Our meta-analysis indicated that the level of circulating miRNAs, particularly the miR-223, could be used as an indicator for sepsis.
Insights
This meta-analysis shows circulating microRNAs (miRNAs) are accurate biomarkers for sepsis diagnosis. Specifically, miR-223 demonstrates strong potential as a sepsis indicator.
Area of Science:
- Biomarkers
- Molecular Diagnostics
- Sepsis Research
Background:
- Sepsis diagnosis relies on clinical criteria and biomarkers like procalcitonin (PCT) and C-reactive protein (CRP).
- Circulating microRNAs (miRNAs) are emerging as potential diagnostic biomarkers due to their stability and role in disease regulation.
- A systematic assessment of miRNA accuracy for sepsis diagnosis is needed.
Purpose of the Study:
- To systematically evaluate the diagnostic accuracy of circulating miRNAs for sepsis using a meta-analysis.
- To compare the accuracy of miRNAs with established sepsis biomarkers (PCT and CRP).
Main Methods:
- A comprehensive literature search was conducted across major databases (PubMed, Cochrane, Embase, Web of Science, Scopus, Ovid) up to April 2020.
- The Quality in Prognostic Studies (QUADAS-2) tool assessed study quality.
- Meta-analysis techniques were employed to calculate pooled sensitivity, specificity, diagnostic odds ratio (DOR), and area under the curve (AUC).
Main Results:
- The meta-analysis included 22 studies with 2210 sepsis cases, 426 systemic inflammatory response syndrome (SIRS) cases, and 1076 healthy controls (HC).
- Circulating miRNAs demonstrated a pooled sensitivity of 0.80, specificity of 0.85, and DOR of 22, outperforming CRP (DOR 7) and comparable to PCT (DOR 17).
- Subgroup analysis revealed superior diagnostic accuracy for miRNAs in adults, serum samples, downregulated expression, Sepsis-3 criteria, non-U6 internal references, and dysregulated miR-223 expression.
Conclusions:
- Circulating miRNAs, particularly miR-223, are accurate and promising biomarkers for sepsis diagnosis.
- The findings support the clinical utility of miRNAs as diagnostic indicators for sepsis.
