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Published on: September 15, 2017
Circulating microRNAs as Diagnostic Markers in Primary Aldosteronism
Scott M MacKenzie1, Hannah Saunders1, Josie C van Kralingen1
1British Heart Foundation Glasgow Cardiovascular Research Centre (BHF GCRC), Institute of Cardiovascular & Medical Sciences (ICAMS), University of Glasgow, Glasgow G12 8TA, UK.
Abstract:
Primary aldosteronism (PA) is a common and highly treatable condition, usually resulting from adrenocortical tumorous growth or hyperplasia. PA is currently underdiagnosed owing to its complex and protracted diagnostic procedures. A simplified biomarker-based test would be highly valuable in reducing cardiovascular morbidity and mortality. Circulating microRNAs are emerging as potential biomarkers for a number of conditions due to their stability and accessibility. PA is known to alter microRNA expression in adrenocortical tissue; if these changes or their effects are mirrored in the circulating miRNA profile, then this could be exploited by a diagnostic test. However, the reproducibility of studies to identify biomarker-circulating microRNAs has proved difficult for other conditions due to a series of technical challenges. Therefore, any studies seeking to definitively identify circulating microRNA biomarkers of PA must address this in their design. To this end, we are currently conducting the circulating microRNA arm of the ongoing ENS@T-HT study. In this review article, we present evidence to support the utility of circulating microRNAs as PA biomarkers, describe the practical challenges to this approach and, using ENS@T-HT as an example, discuss how these might be overcome.
Insights
Primary aldosteronism (PA) diagnosis may be simplified using circulating microRNAs (miRNAs) as biomarkers. This approach aims to overcome challenges in current diagnostic methods and reduce cardiovascular risks associated with underdiagnosed PA.
Area of Science:
- Endocrinology
- Molecular Biology
- Biomarker Discovery
Background:
- Primary aldosteronism (PA) is a prevalent, treatable endocrine disorder often underdiagnosed due to complex diagnostics.
- Underdiagnosis of PA contributes significantly to cardiovascular morbidity and mortality.
- A simplified diagnostic approach is needed to improve patient outcomes.
Purpose of the Study:
- To review the potential of circulating microRNAs (miRNAs) as biomarkers for primary aldosteronism.
- To discuss the challenges in identifying reproducible circulating miRNA biomarkers.
- To present strategies for overcoming these challenges, exemplified by the ENS@T-HT study.
Main Methods:
- Review of existing literature on microRNA expression in primary aldosteronism.
- Analysis of technical challenges impacting the reproducibility of circulating miRNA biomarker studies.
- Description of the ongoing ENS@T-HT study's approach to identifying circulating miRNA biomarkers for PA.
Main Results:
- Evidence suggests circulating miRNAs are altered in primary aldosteronism and could serve as diagnostic biomarkers.
- Significant technical and reproducibility challenges exist in identifying reliable circulating miRNA biomarkers.
- The ENS@T-HT study is designed to address these challenges through a robust methodology.
Conclusions:
- Circulating miRNAs hold promise as accessible biomarkers for primary aldosteronism, potentially simplifying diagnosis.
- Overcoming reproducibility issues is critical for the clinical utility of miRNA-based diagnostics.
- Methodological rigor, as employed in studies like ENS@T-HT, is essential for validating these biomarkers.
