The Predictive Value of microRNA-134 and microRNA-1233 for the Early Diagnosis of Acute Exacerbation of Chronic Obstructive Pulmonary Disease with Acute Pulmonary Embolism
Received 26 June 2020
Accepted for publication 22 September 2020
Published 15 October 2020 Volume 2020:15 Pages 2495—2503
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Dr Richard Russell
Ling Peng,1,2 Li Han,2 Xiao-Ning Li,2 Ya-Fang Miao,2 Fei Xue,2 Chao Zhou1,3
1School of Clinical Medicine, Guizhou Medical University, Guiyang, Guizhou, People’s Republic of China; 2Department of Respiratory Medicine, Zhoupu Hospital Affiliated to Shanghai University of Medicine and Health Sciences, Shanghai, People’s Republic of China; 3Department of Respiratory Medicine, Guangming Traditional Chinese Medicine Hospital of Pudong New Area, Shanghai, People’s Republic of China
Correspondence: Chao Zhou
Department of Respiratory Medicine, Guangming Traditional Chinese Medicine Hospital of Pudong New Area, No. 339 DongMen Street. Pudong New District, Shanghai 201399, People’s Republic of China
Background: The differential diagnosis of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) with acute pulmonary embolism (APE) complications are difficult because of the variability of clinical presentations and the shortage of an unfailing screening biomarkers or instruments.
Objective: Aimed to detect and compare the expression of serum microRNAs (miR-1233, miR-134) in AECOPD patients complicated with APE.
Patients/Methods: Blood samples were collected from 52 AECOPD patients (13 patients with APE complications, 39 patients without APE) and 10 patients with stable COPD. Serum miRNAs expression was detected with real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). The levels of plasma D-dimers were determined by detection with an enzyme-linked immunosorbent assay (ELISA). The receiver-operator characteristic (ROC) curve was used for evaluating the diagnostic accuracy of the studied miRNAs.
Results: According to the Wells score, 42 of the 52 AECOPD patients were unlikely to have APE (≤ 4 points), whereas the remaining 10 (> 4 points) were likely to have APE. There were 4 cases (4/13 30.8%) in the AECOPD combined with APE group with a Wells score of > 4 points. The expression levels of miR-1233 and miR-134 in the serum were considerably upregulated in the AECOPD+APE group compared with the AECOPD group and the stable COPD group (P< 0.05). The areas under the curve (AUCs) for miR-134 and miR-1233 were, respectively, 0.931 (95% CI 0.863– 0.999) (P< 0.05) and 0.884 (95% CI 0.79– 0.978) (P< 0.05) and were higher compared with the AUC for D-dimer of 0.628 (95% CI 0.447– 0.809), the AUC for age-adjusted D-dimer of 0.705 (95% CI 0.525– 0.885) and the AUC for Wells score of 0.577 (95% CI 0.389– 0.765).
Conclusion: Our study indicated that serum miR-1233 and miR-134 have high clinical value in the early diagnosis of AECOPD patients combined with APE, or could be used as potential biomarkers for clinical identification of AECOPD with or without APE complication.
Keywords: acute exacerbation of chronic obstructive pulmonary disease, acute pulmonary embolism, D-dimer, microRNA, biomarker