Transcriptomic analysis identified novel biomarker in invasive placenta accreta spectrum

Area of Science:

• Obstetrics and Gynecology
• Molecular Biology
• Biomarker Discovery

Background:

• Placenta accreta spectrum (PAS) disorders present severe maternal risks, including hemorrhage and peripartum hysterectomy.
• There is a critical need for reliable circulating biomarkers for early PAS detection and management.
• MicroRNAs (miRNAs) are stable in circulation and show potential as diagnostic markers.

Purpose of the Study:

• To identify and validate circulating miRNA biomarkers for placenta accreta spectrum (PAS).
• To evaluate the diagnostic performance of identified biomarkers for PAS and associated adverse outcomes.

Main Methods:

• RNA sequencing (RNA-seq) of peripheral blood to identify candidate miRNAs in PAS patients and controls.
• Quantitative reverse transcription PCR (qRT-PCR) to validate miR-23a-5p and its target genes (ASF1B, CHTF8).
• Receiver Operating Characteristic (ROC) curve analysis to assess diagnostic accuracy.

Main Results:

• miR-23a-5p was significantly down-regulated in PAS, while its target genes ASF1B and CHTF8 were up-regulated.
• Individual miR-23a-5p showed modest diagnostic efficiency for PAS (AUC=0.689) and adverse outcomes (AUC=0.711).
• Combining miR-23a-5p with CHTF8 substantially improved diagnostic AUC for PAS (0.869) and adverse outcomes (0.856).

Conclusions:

• miR-23a-5p, potentially through regulating cell proliferation and apoptosis, plays a role in PAS pathogenesis.
• The combination of miR-23a-5p and CHTF8 demonstrates significant potential as novel biomarkers for PAS diagnosis and adverse outcome prediction.