Evaluation of capillary miR-122 as a prognostic biomarker of paracetamol-induced liver toxicity.

Abstract

Paracetamol (acetaminophen) overdose is a leading cause of acute liver failure in many Western countries. Diagnostic tools for this poisoning may be suboptimal in some cases and new biomarkers have been investigated. We investigated the role of capillary microRNA-122 (miR-122) as a prognostic biomarker of liver injury in the clinical management of patients with paracetamol overdose. In a paracetamol overdose patient cohort, miR-122 was measured by quantitative polymerase chain reaction in a blood drop obtained by a finger prick at the end of an antidote cycle treatment with N-acetylcysteine treatment (12h). Liver injury was defined as serum alanine aminotransferase (ALT) activity > 100IU/L collected at 10 or 20h after the start of treatment. Pearson's correlation analyses were performed. In patients with paracetamol overdose, capillary miR-122 was positively correlated with ALT measured at 10h and at 20h (r = 0.83, P < 0.0001; r = 0.96, P < 0.0001, respectively). This work supports the potential use of capillary miR-122 as a prognostic biomarker of liver injury throughout clinical management of patients with paracetamol overdose. Capillary miR-122 can be measured in a blood drop collected by a finger prick, a minimally invasive diagnostic test for patient stratification.