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Related Concept Videos

MicroRNAs01:22

MicroRNAs

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MicroRNA (miRNA) are short, regulatory RNA transcribed from introns (non-coding regions of a gene) or intergenic regions (stretches of DNA present between genes). Several processing steps are required to form biologically active, mature miRNA. The initial transcript, called primary miRNA (pri-mRNA), base-pairs with itself, forming a stem-loop structure. Within the nucleus, an endonuclease enzyme, called Drosha, shortens the stem-loop structure into hairpin-shaped pre-miRNA. After the pre-miRNA...
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Identification of Heart Transplant Rejection Subtypes With Circulating MicroRNAs.

Jason F Goldberg1,2,3, Pramita Bagchi4, Angela Mercado5

  • 1Inova Children's Hospital, Falls Church, VA (J.F.G.).

Circulation. Heart Failure
|January 12, 2026
PubMed
Summary
This summary is machine-generated.

Circulating microRNAs show high accuracy in identifying acute cellular rejection (ACR) and antibody-mediated rejection (AMR) in heart transplant recipients. Elevated microRNA clinical rejection scores (CRS) predict increased risk of future rejection, allograft dysfunction, or death.

Keywords:
allograftbiomarkersgenomicsheart transplantationmicroRNAs

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Area of Science:

  • Transplantation immunology
  • Biomarker discovery
  • Molecular diagnostics

Background:

  • Circulating microRNAs are potential biomarkers for acute cellular rejection (ACR) and antibody-mediated rejection (AMR) after heart transplantation.
  • Assessing microRNA characteristics and diagnostic performance alongside clinical rejection scores (CRS) using blood samples at endomyocardial biopsy (EMB) is crucial.

Purpose of the Study:

  • To evaluate the diagnostic accuracy of microRNAs and CRS for detecting ACR and AMR.
  • To determine the predictive value of microRNA-based CRS for long-term transplant outcomes.

Main Methods:

  • Prospective longitudinal cohort study (GRAfT) involving microRNA sequencing on blood samples from heart transplant recipients.
  • Logistic regression modeling to develop ACR and AMR CRS based on previously identified microRNAs.
  • Receiver-operating characteristic (ROC) curve analysis for diagnostic performance and Cox proportional hazard models for outcome prediction.

Main Results:

  • High diagnostic performance for CRS: AUC 0.93 for ACR and 0.92 for AMR.
  • Elevated CRS (threshold 65) demonstrated high sensitivity and specificity for both ACR and AMR.
  • A 10-point increase in CRS was significantly associated with increased hazard for subsequent rejection, allograft dysfunction, or death.

Conclusions:

  • Circulating microRNAs reliably identify ACR and AMR, correlating with EMB findings.
  • MicroRNA-based CRS serves as a valuable noninvasive tool for screening and diagnosing rejection.
  • Further validation could establish microRNA CRS as a substitute for EMB in managing heart transplant recipients.