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NEAT1/miR-139-5p as biomarkers for opioid tolerance following total knee arthroplasty
Qiu Chen1, Dongli Jie2, Yanfei Dong3
1Department of Anesthesiology and Pain Management, Wuhan Asia General Hospital, Wuhan 430056, Hubei, China.
Objectives:
To investigate the predictive value and regulatory relationship of serum long non-coding RNA NEAT1 and microRNA miR-139-5p for acute opioid tolerance following Total Knee Arthroplasty (TKA).
Methods:
A prospective cohort of TKA patients was enrolled and divided into the opioid tolerance group (OTG) and the non-opioid tolerance group (ONTG). The expression levels of NEAT1 and miR-139-5p in serum were measured at preoperative, postoperative day 1, and day 3 using qRT-PCR. Their clinical value was evaluated using correlation analysis, multivariate logistic regression, and ROC curve analysis.
Results:
Compared to the ONTG group, the OTG group showed significantly upregulated NEAT1 and downregulated miR-139-5p (both P < 0.001), with a strong negative correlation between the two (r = -0.843∼-0.876). NEAT1 was positively correlated with postoperative opioid consumption and VAS scores, while miR-139-5p showed a negative correlation (all P < 0.001). Multivariate logistic regression confirmed that NEAT1 and miR-139-5p on postoperative day 1 and day 3 were independent predictive factors (both P < 0.05). ROC curve analysis demonstrated that both markers had good predictive accuracy on postoperative day 1 (AUC = 0.792, 0.845) and day 3 (AUC = 0.819, 0.867).
Conclusion:
NEAT1 and miR-139-5p participate in TKA postoperative opioid tolerance through the ceRNA mechanism. Their expression levels on postoperative day 1 are independent risk factors with good predictive accuracy for postoperative opioid tolerance, making them potential early predictive biomarkers.
