Association of microRNAs with cerebral atherosclerosis progression: the role of endovascular interventions

Atherosclerosis of the brachiocephalic arteries is one of the leading causes of ischemic cerebrovascular disorders, which is based on a complex, multi-stage process regulated by epigenetic mechanisms. The latter, in particular, include changes in the expression of molecules such as microRNAs - small (on average, 22 nucleotides) non-coding RNA sequences that are heavily involved in most physiological and pathological processes.

The aim of the study was to evaluate the expression of miR-126-5p/-3p, miR-21-5p/-3p, miR-33a-5p/-3p, miR-29a-5p/-3p in relation to association with clinical cerebrovascular events and to identify differences in the expression pattern depending on the performed transluminal balloon angioplasty with carotid artery stenting for hemodynamically significant carotid stenosis.

Our prospective study included 80 patients [average age - 66 years, men - 44 (55%)] with cerebral atherosclerosis of varying severity who were admitted to the vascular departments of the 'Research Center of Neurology' (Moscow). Transluminal balloon angioplasty with stenting (TBAS) of the carotid artery was performed in 33 patients [in 14 (42%) patients - for symptomatic stenosis]. All patients underwent thorough clinical and neurological examination, laboratory and instrumental research methods, including isolation and analysis of microRNA expression (miR-126-5p/-3p, miR-21-5p/-3p, miR-33a-5p/-3p, miR-29a-5p/-3p).

The microRNA expression pattern was significantly different in the patients who underwent TBAS: the levels of miR-126-5p/-3p and miR-29a-5p were statistically significantly lower, and those of miR-33a-5p/-3p higher compared with the patients who did not undergo angiosurgery. A multivariate linear regression model that included the expression of all the microRNAs studied identified miR-126-5p and miR-21-5p as statistically significant independent predictors of the degree of carotid artery stenosis.

The expression of a number of atherogenic microRNAs in patients who underwent transluminal angioplasty with carotid artery stenting appeared to be of a differentiated nature. The most significant biomarker was the expression level of miR-126-5p, which is associated, among other things, with the degree of carotid stenosis.