Urine-Derived Extracellular Vesicle miRNAs as Possible Biomarkers for and Mediators of Necrotizing Enterocolitis: A Proof of Concept Study
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In brief
In brief
This proof-of-concept study identifies urine-derived extracellular vesicle microRNAs as potential biomarkers to differentiate necrotizing enterocolitis from non-NEC sepsis in neonates. Non-invasive urine sampling revealed specific miRNAs (miR-376a, miR-518a-3p, miR-604) significantly altered in NEC patients, offering a pathway toward earlier, more targeted treatment decisions in critically ill infants.
Written by the GCMD Library team from the article.
Abstract
Background
Early-stage symptomology of necrotizing enterocolitis (NEC) is similar in presentation to non-NEC sepsis, though the treatment plans differ based on antibiotic administration and withholding of feeds. Improved diagnostics for NEC differentiation would allow clinicians to more rapidly set individual patients on a targeted treatment path. Extracellular vesicle-derived miRNAs, have previously demonstrated efficacy as disease biomarkers. To determine if these miRNAs are differentially-expressed in NEC infants, we performed transcriptomic analysis of urine-derived extracellular vesicle-derived miRNAs.
Methods
Urine was non-invasively obtained from infants in one of four groups (n ≥ 8) (Medical NEC, Surgical NEC, non-NEC sepsis, and healthy age-matched controls). EV-derived miRNAs were isolated and transcriptomic analysis was performed.
Results
Multiple miRNAs, including miR-376a, miR-518a-3p and miR-604, were significantly altered when comparing NEC to non-NEC sepsis and healthy controls, and could potentially be used as specific NEC biomarkers. Additionally, Ingenuity Pathway Analysis demonstrated that miRs differentially-expressed in NEC were associated with inflammatory disease and intestinal disease. Signal transduction molecules associated with NEC including TP53 and RPS15, which were also reduced transcriptionally in a rat model of NEC.
Conclusion
These data indicate that there is a pool of potential urine EV-derived miRNAs that may be validated as NEC biomarkers in the differentiation of NEC from non-NEC sepsis and from age-matched controls. Additionally, signal transduction molecules associated with miRNAs differentially-expressed in human NEC are altered in a murine model of NEC, suggesting potential crossover between murine models of the disease and actual human presentation.
Level of Evidence
Level III Study of Diagnostic Test.