Plasma and local expressions of CircRNA CDR1as are linked with disease severity in patients with non-traumatic osteonecrosis of femoral head

Bin Jiang,Ji-Yong Zeng,Shu-Hua Zhu,Zheng Mao

doi:10.1186/s13018-020-02129-z

Abstract

ObjectiveTo investigate the correlation of plasma and local expressions of Circ CDR1as with disease severity in patients with non-traumatic osteonecrosis of femoral head (ONFH).MethodsNinety-nine non-traumatic ONFH patients receiving surgery and 99 healthy individuals were enrolled in our study. Plasma and local Circ CDR1as were detected using real-time quantitative PCR (RT-qPCR). Radiographic progression was determined using Association Research Circulation Osseous (ARCO) classification system. Harris hip score (HHS) and visual analogue scale (VAS) were used to assess the clinical severity. Receiver operating characteristic (ROC) curve was carried out to evaluate the diagnostic value of plasma Circ CDR1as with regard to the radiographic severity.ResultsPlasma Circ CDR1as expressions were significantly higher in non-traumatic ONFH patients compared with healthy controls. In non-traumatic ONFH patients, there were no significant differences of CircCDR1as expressions between patients with alcohol-induced ONFH and steroid-induced ONFH. CircCDR1as in local necrotic tissue were significantly higher than adjacent non-affected tissue. Plasma and local Circ CDR1as expressions in patients with ARCO phase 4 were markedly upregulated compared with ARCO phase 3; plasma and local Circ CDR1as expressions in patients with ARCO phase 3 were markedly upregulated compared with ARCO phase 1/2. Plasma and local CircCDR1as expressions were positively associated with ARCO classification. In addition, plasma and local Circ CDR1as expressions were positively correlated with VAS and HHS scores. ROC curve analysis indicated that plasma Circ CDR1as may act as a decent marker for radiographic progression in non-traumatic ONFH patients.ConclusionsBoth plasma and local expressions of CircRNA CDR1as are linked with disease severity in patients with non-traumatic ONFH.

Highlights

Non-traumatic osteonecrosis of the femoral head (ONFH) is a common disease characterized by death of bone cells due to insufficient blood flow [1], leading to high disability rate and severe influence on life quality [2]
Plasma CircCDR1as expressions in non-traumatic Osteonecrosis of femoral head (ONFH) patients As depicted in Fig. 1, non-traumatic ONFH patients demonstrated significantly upregulated plasma CircCDR1as expressions compared with healthy controls (1.93 ± 0.32 vs 1.0 0 ± 0.06, P < 0.001) (Fig. 1a)
There was no significant difference in plasma and local CircCDR1as expressions between GC-induced and alcohol-induced ONFH patients (Fig. 1b)

Summary

Introduction

Non-traumatic osteonecrosis of the femoral head (ONFH) is a common disease characterized by death of bone cells due to insufficient blood flow [1], leading to high disability rate and severe influence on life quality [2]. Circular RNA (circRNA) is a new class of endogenously expressed non-coding RNA, which is characterized by covalently closed loop structures with neither 5' to 3' polarity nor polyadenylated tail [7]. They are common in mammalian cells and regulate gene expression at the transcriptional or post-transcriptional level by interacting with microRNAs (miRNAs) or other molecules [8,9,10]. High abundance, relative stability, tissue/developmental stage-specific expression, and evolutionary conservation among species make circRNAs very attractive for clinical application [11] Due to these characteristics, circRNAs have a great potential to serve as significant biomarkers to diagnose diseases. Circulating circRNAs have been reported to be used as potential biomarkers for the diagnosis and prognosis of various diseases including cancer [12, 13], essential hypertension [14], diabetes [15], and amyotrophic lateral sclerosis [16], etc

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