Abstract

BackgroundHepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening disease with a high mortality rate; the systemic inflammatory response plays a vital role in disease progression. We aimed to determine if a miRNA–mRNA co-regulatory network exists in the peripheral blood mononuclear cells (PBMCs) of HBV-ACLF patients, which might be important for prognosis.MethodsTranscriptome-wide microRNA (miRNA) and mRNA microarrays were used to define the miRNA and mRNA expression profiles of the PBMCs of HBV-ACLF patients in a discovery cohort. The targets of the miRNAs were predicted. We built a miRNA-mRNA regulatory network through bioinformatics analysis, and used quantitative real-time polymerase chain reaction (qRT-PCR) to assess the importance of candidate miRNAs and mRNAs. We also assessed the direct and transcriptional regulatory effects of miRNAs on target mRNAs using a dual-luciferase reporter assay.ResultsThe miRNA/mRNA PBMC expression profiles of the discovery cohort, of whom eight survived and eight died, revealed a prognostic interactive network involving 38 miRNAs and 313 mRNAs; this was constructed by identifying the target genes of the miRNAs. We validated the expression data in another cohort, of whom 43 survived and 35 died; miR-6840-3p, miR-6861-3p, JADE2, and NR3C2 were of particular interest. The levels of miR-6840-3p and miR-6861-3p were significantly increased in the PBMCs of the patients who died, and thus predicted prognosis (areas under the curve values = 0.665 and 0.700, respectively). The dual-luciferase reporter assay indicated that miR-6840-3p directly targeted JADE2.ConclusionWe identified a prognostic miRNA-mRNA co-regulatory network in the PBMCs of HBV-ACLF patients. miR-6840-3p-JADE2 is a potential miRNA–mRNA pair contributing to a poor prognosis.

Highlights

  • Acute-on-chronic liver failure (ACLF) is a life-threatening disease characterized by acute deterioration of liver function in patients with pre-existing chronic liver disease, and hepatic or extrahepatic organ failure (Bernal et al, 2015)

  • We aimed to determine if a miRNA–mRNA co-regulatory network exists in the peripheral blood mononuclear cells (PBMCs) of HBVACLF patients, which might be important for prognosis

  • The miRNA/mRNA Peripheral blood mononuclear cells (PBMCs) expression profiles of the discovery cohort, of whom eight survived and eight died, revealed a prognostic interactive network involving 38 miRNAs and 313 mRNAs; this was constructed by identifying the target genes of the miRNAs

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Summary

Introduction

Acute-on-chronic liver failure (ACLF) is a life-threatening disease characterized by acute deterioration of liver function in patients with pre-existing chronic liver disease, and hepatic or extrahepatic organ failure (Bernal et al, 2015). The incidence rates of ACLF and acute liver failure vary worldwide. Peripheral blood mononuclear cells (PBMCs), which are important components of the immune system, play pivotal roles in inflammation and immune system deterioration. A previous study described the differential transcriptome profiles of the PBMCs of healthy controls, and patients with chronic hepatitis B infections and HBV-ACLF (Zhou et al, 2016), but did not explore the relationship between transcriptional status and the prognosis of HBV-ACLF. Hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is a life-threatening disease with a high mortality rate; the systemic inflammatory response plays a vital role in disease progression. We aimed to determine if a miRNA–mRNA co-regulatory network exists in the peripheral blood mononuclear cells (PBMCs) of HBVACLF patients, which might be important for prognosis

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