Kosin Med J.  2022 Sep;37(3):242-248. 10.7180/kmj.22.116.

The clinical significance of circulating microRNA-21 in patients with IgA nephropathy

• Cho AY
• Oh JH
• Lee KY
• Sun IO

• KMID: 2538804
• DOI: http://doi.org/10.7180/kmj.22.116

Abstract

Background
Urinary microRNA-21 (miR-21) has been reported to correlate with the histologic lesions of IgA nephropathy (IgAN). We investigated whether urinary or circulating miR-21 could serve as a biomarker for detecting the renal progression of IgAN.
Methods
Forty patients with biopsy-proven IgAN were enrolled in this study. Serum and urinary sediment miRs were extracted, and the expression of miR-21 was quantified by real-time quantitative polymerase chain reaction. Renal progression was defined as end-stage renal disease, a sustained doubling of serum creatinine, or a 50% decrease in estimated glomerular filtration rate (eGFR) from baseline.
Results
Six patients experienced renal progression during the follow-up period. The baseline eGFR was lower in the progression group (49±11 mL/min/1.73 m2 vs. 90±23 mL/min/1.73 m2, p<0.05) than in the non-progression group. The level of circulating miR-21 on kidney biopsy was higher in the progression group than in the non-progression group (40.0±0.6 vs. 38.2±1.1 ΔCt value of miR-21, p<0.01), whereas there was no significant difference in urinary miR-21 (38.1±2.1 vs. 37.8±1.4 ΔCt value of miR-21, p=0.687) between the two groups. Receiver operating characteristic curve analysis demonstrated that circulating miR-21 had good discriminative power for diagnosing renal progression of IgAN, with an area under the curve of 0.975.
Conclusions
The level of circulating miR-21 was higher in the progression group than in the non-progression group at the time of kidney biopsy. Therefore, circulating miR-21 could be a surrogate marker of renal progression in patients with IgAN.

Keyword

Glomerulonephritis; Immunoglobulin A; MicroRNAs

Figure

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  Fig. 1. Correlation of circulating microRNA-21 (miR-21) with clinical parameters. Circulating miR-21 levels correlated directly with proteinuria (A) and inversely with the estimated glomerular filtration rate (eGFR) (B).

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  Fig. 2. Receiver operating characteristic curve and performance for circulating microRNA-21 (miR-21) at the time of kidney biopsy. The area under the receiver operating characteristic curve (AUC) was 0.975 for circulating miRNA-21.

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  Fig. 3. Circulating microRNA-21 (miR-21) levels were higher in patients with severe fibrosis than in those with mild fibrosis. After reference gene normalization, the relative expression intensity of circulating miR-21 was higher in patients with severe fibrosis than in patients with mild fibrosis.

Reference

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