microRNA Biomarkers in Paediatric Infection Diagnostics-Bridging the Gap Between Evidence and Clinical Application: A...

Area of Science:

• Biochemistry
• Molecular Biology
• Pediatrics

Background:

• Differentiating pediatric bacterial and viral infections is challenging, often leading to antibiotic overuse.
• Rising antimicrobial resistance necessitates novel diagnostic biomarkers.
• Host microRNAs (miRNAs) are emerging as potential indicators of infection type.

Purpose of the Study:

• To review current host miRNA biomarkers for acute bacterial and viral infections in children (0-18 years).
• To analyze study methodologies, diagnostic performance, and identify research gaps for clinical application.

Main Methods:

• A scoping review of 1147 identified articles, including 36 studies.
• Focused on studies examining host miRNAs in pediatric infections.
• Evaluated study designs, diagnostic accuracy metrics, and reported miRNA candidates.

Main Results:

• 17 miRNAs were validated in multiple studies; 3 (hsa-miR-182-5p, hsa-miR-363-3p, hsa-miR-206) linked to bacterial infections.
• 9 miRNAs (e.g., hsa-miR-155, hsa-miR-29a-3p) associated with viral infections.
• Reported sensitivities (70-100%) and specificities (72-100%) show biomarker potential, with AUCs ranging from 0.62 to 0.99.

Conclusions:

• miRNA biomarkers hold significant potential for diagnosing pediatric infections with rigorous validation.
• Clinical translation is hindered by inconsistent adherence to reporting guidelines (STARD) and study heterogeneity.
• Case-control designs, common in current research, may identify non-specific markers, limiting diagnostic utility.