Zhongguo cuzhong zazhi (Oct 2024)
急性缺血性卒中患者静脉溶栓后血清微小RNA-874-3p、微小RNA-181a-5p及Wnt/β-catenin信号通路与神经功能预后的关系 Relationship between Serum MicroRNA-874-3p, MicroRNA-181a-5p, Wnt/β-catenin Signaling Pathway and Neurological Function Prognosis in Patients with Acute Ischemic Stroke after Intravenous Thrombolysis
Abstract
Abstract: Objective To investigate the relationship between serum microRNA-874-3p (miR-874-3p), microRNA-181a-5p (miR-181a-5p), Wnt/β-catenin signaling pathway and neurological function prognosis in patients with acute ischemic stroke (AIS). Methods AIS patients who received intravenous thrombolytic therapy in Shenzhen Longhua District Central Hospital from March 2021 to December 2022 were prospectively included into the AIS group, and healthy subjects during the same period were selected into the control group. The relative expression levels of serum miR-874-3p, miR-181a-5p and peripheral blood mononuclear cell (PBMC) determination of Wnt/β-catenin were detected and compared between the two groups. Pearson correlation was used to analyze the correlation between the expression of miR-874-3p and miR-181a-5p in serum and the Wnt/β-catenin signaling pathway in AIS patients. All AIS patients were followed up for 3 months after discharge. Patients who completed follow-up were divided into the good neurological function prognosis group and the poor neurological function prognosis group based on the mRS score. The relative expression levels of miR-874-3p and miR-181a-5p were compared between the two groups. Multivariate logistic regression equation was used to analyze the factors affecting the prognosis of neurological function in AIS patients. Results In this study, 185 patients were included in the AIS group, with an average age of (62.8±7.3) years. The control group included 65 healthy subjects with an average age of (63.4±6.9) years. Compared with the control group, the relative expression levels of miR-874-3p in serum (1.02±0.21 vs. 1.46±0.23, P<0.001) and Wnt mRNA (2.41±0.64 vs. 4.59±1.13, P<0.001), β-catenin mRNA in PBMC (1.19±0.18 vs. 2.34±0.73, P<0.001) in the AIS group were lower than those in the control group. The relative expression level of miR-181a-5p (1.95±0.32 vs. 1.27±0.27, P<0.001) was higher than that of the control group. Pearson correlation analysis showed that the expression of serum miR-874-3p was positively correlated with the expression of Wnt mRNA (r=0.562, P<0.001) and β-catenin mRNA (r=0.611, P<0.001) in PBMC, while the expression of miR-181a-5p was negatively correlated with the expression of Wnt mRNA (r=-0.586, P<0.001) and β-catenin mRNA (r=-0.595, P<0.001) in PBMC in AIS patients. In the AIS group, there were 104 patients with good neurological function prognosis and 81 patients with poor neurological function prognosis. The rate of poor neurological function prognosis was 43.78%. The relative expression level of miR-874-3p in serum in the poor neurological function prognosis group was significantly lower than that in the good neurological function prognosis group (0.79±0.20 vs. 1.20±0.22, P<0.001). The relative expression level of miR-181a-5p was significantly higher than that of the good neurological function prognosis group (2.26±0.31 vs. 1.71±0.24, P<0.001). In the poor neurological function prognosis group, age [(65.48±7.45) years vs. (62.29±7.21) years, P=0.004], time from onset to admission[(4.36±1.03) h vs. (3.79±1.15) h, P=0.001], the NIHSS score [(6.81±2.45) points vs. (4.67±1.76) points, P<0.001] and serum Hcy levels [(13.34±4.12) μmol/L vs. (11.75±3.46) μmol/L, P=0.005] were significantly higher than those in the good neurological function prognosis group. Multivariate logistic regression results showed that older age (OR 1.056, 95%CI 1.005-1.108, P=0.029), extend time from onset to admission (OR 1.125, 95%CI 1.008-1.256, P=0.035), high NIHSS score (OR 1.220, 95%CI 1.093-1.362, P<0.001), low expression of miR-874-3p (OR 0.632, 95%CI 0.498-0.803, P<0.001), and high expression of miR-181a-5p (OR 1.506, 95%CI 1.209-1.875, P<0.001) were risk factors for poor prognosis of AIS neurological function. Conclusions The expression of serum miR-874-3p decreased and miR-181a-5p increased in AIS patients, both of which were related to the Wnt/β-catenin signaling pathway. The levels of serum miR-874-3p and miR-181a-5p were influencing factors for the prognosis of neurological function in patients.
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