Diagnostic And Predictive Significance Of MicroRNA Level In Plasma For AGVHD After Hematopoietic Stem Cell Transplantation

Objective:Allogeneic hematopoietic stem cell transplantation is the only way to cure most hematological diseases.Acute graft-versus-host disease is the most important cause of death.Due to the difficulty of aGVHD treatment,early prediction or diagnosis of acute graft-versus-host disease is of great value to improve the prognosis of patients.This paper aims to study the correlation between the changes of the expression levels of miR-181b and miR-194 in plasma and the occurrence of acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation,and to establish a new diagnostic or predictive index for aGVHD.Methods:In this experiment,31 patients after allogeneic hematopoietic stem cell transplantation,21 cases of patients with thalassemia,6 patients with acute leukemia,3 cases of patients with aplastic anemia and 1 patient with hemophagocytic syndrome were observed.Among them,13 patients developed acute graf t-versus-hos t disease(9 cases of thalassemia,2 cases of acute leukemia,1 cases of aplastic anemia),and 18 cases of patients did not develop acute graft-versus-host disease.Qrt-PCR was used to detect whether the expression of two microRNA(miR-181b,miR-194)in peripheral blood plasma was different in patients with acute graf t-versus-host disease after allogeneic hematopoietic stem cell transplantation,and whether the expression levels of the two miRNAs in plasma were different after acute graf t-versus-host disease patients were treated.The expression levels of the two miRNAs were calculated and analyzed statistically to see if they have statistical significance and diagnostic or predictive value.Results:1.Compared with the healthy control group,the expression levels of miR-181b and miR-194 in the plasma of patients before transplantation had no statistical difference(P>0.05).2.The expression levels of miR-181b and miR-194 in plasma of patients without aGVHD before and after transplantation had no statistical difference(P>0.05).3.The expression levels of miR-181b and miR-194 in the plasma of aGVHD patients were increased(P<0.05),and decreased after treatment(P<0.05).4.Through establishing ROC curve to evaluate the diagnostic efficiency of miR-181b and miR-194,miR-181b and miR-194 have certain diagnostic value for aGVHD(P<0.05for both).AUC value of miR-181b is 0.9124,specificity is 94.44%,and sensitivity is 69.23%.AUC value of miR-194 is 0.9103,specificity is 94.44%,and sensitivity is 76.92%.5.The diagnostic efficiency of miR-181b and miR-194 was evaluated by establishing ROC curve.miR-181b and miR-194 have certain predictive value for aGVHD(P<0.05 for both).AUC value of miR-181b is 0.8965,specificity is 88.89%,and sensitivity is 72.73%.AUC value of miR-194 is 0.8939,specificity is 88.89%,and sensitivity is 81.82%.Conclusions:1.miR-181b and miR-194 have diagnostic value for acute graft-versus-host disease in patients after allogeneic hematopoietic stem cell transplantation.2.miR-181b and miR-194 have certain predictive value for patients with acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation.3.miR-181b and miR-194 have certain evaluation significance on the effect of acute graft-versus-host disease after treatment.