系统性红斑狼疮患者血浆miRNA-23a表达的检测及意义

目的：分析miR-23a在系统性红斑狼疮（SLE）患者血浆中的表达及临床意义。方法：收集54例SLE患者、16例类风湿性关节炎（RA）患者和20例健康对照血浆标本，抽提血浆小RNA，反转录后，以cel-miR-39为外参，通过定量PCR检测血浆miR-23a的表达，统计分析miR-23a表达水平与临床资料的相关性。结果：miR-23a在SLE患者、健康对照和RA患者血浆中的相对表达量差异具有统计学意义（x2=39.199，P＜0.001）。与RA患者及健康对照比较，SLE患者血浆中miR-23a表达水平明显下调（P＜0.05）。受试者工作特征曲线（ROC曲线）分析显示，血浆miR-23a区分SLE患者和健康对照以及RA患者的ROC曲线下面积（AUC）分别为0.931和0.884。血浆miR-23a表达水平以19.22临界值区分SLE患者和健康对照的特异性和敏感性达74.5%和88.9%；以30.98临界值区分SLE与RA患者的特异性和敏感性达73.3%和86.3%。血浆miR-23a的表达水平与SLE临床检测指标的相关性分析显示，血浆miR-23a的表达水平与抗核抗体（ANA）滴度水平及血白细胞计数（P＜0.05）相关。结论：SLE患者血浆中下调表达的miR-23a可能与其发病和病情进展相关，是SLE临床诊断一个新的生物学指标。

Detection of the plasma miR-23a expression in systemic lupus erythematosus and its clinical significance

Objective: To explore miR-23a expression and its clinical significance in the plasma of systemic lupus erythematosus (SLE) patients. Methods: Plasma samples from 54 SLE patients, 16 rheumatoid arthritis (RA) patients and 20 healthy controls were collected. The small RNAs in these plasma samples were isolated and reversely transcribed. Using cel-miR-39 as the external reference, the levels of miR-23a expression were detected with real-time polymerase chain reaction (PCR) method. The correlation between the levels of miR-23a expression and the clinical pathological features of SLE and biological significance of miR-23a expression in SLE were further analyzed with statistical methods. Results: Our data indicated that the levels of miR-23a expression in the plasma of SLE patients, RA patients and healthy controls were significantly different (x2=39.199, P<0.001). The level of miR-23a in the plasma of SLE patients was statistically lower than that in RA patients and healthy controls (P<0.05). The area under the ROC (receiver-operating characteristic) curve (AUC) was 0.931 for discriminating between SLE patients and normal subjects and 0.884 for discriminating between SLE and RA patients and patients. The levels of miR-23a expression were set the cutoff values of 19.22 for healthy control and 30.98 for RA patients, the diagnostic sensitivity and specificity were 74.5%, 88.9%, and 73.3%, 86.3%, respectively. The analysis of the correlation between miR-23a expression and the clinical pathological features of SLE shown that the levels of plasma miR-23a expression had positively correlated with anti-ANA titers and negatively correlated with white blood cell count (P<0.05). Conclusion: Down-regulated of miR-23a expression in plasma of SLE may be involved in the SLE disease occurrence or development and can be used as a novel potential diagnostic biomarker for SLE.