Abstract

Hepatitis E virus (HEV) genotypes 3 and 4 (HEV-3, HEV-4) infections are an emerging public health issue in industrialized countries. HEV-3 and −4 are usually self-limiting but can progress to chronic hepatitis E in immunocompromised individuals. The molecular mechanisms involved in persistent infections are poorly understood. Micro RNAs (miRNAs) can regulate viral pathogenesis and can serve as novel disease biomarkers. We aimed to explore the modulation of serum miRNAs in patients with acute (AHE) and chronic (CHE) hepatitis E. Both AHE- and CHE-patients exhibited high viral loads (median 3.23E + 05 IU/mL and 2.11E + 06 IU/mL, respectively) with HEV-3c being the predominant HEV-genotype. Expression analysis of liver-specific serum miRNAs was performed using real-time PCR. miR-99a-5p, miR-122-5p, and miR-125b-5p were upregulated in AHE (4.70–5.28 fold) and CHE patients (2.28–6.34 fold), compared to HEV-negative controls. Notably, miR-192-5p was increased 2.57 fold while miR-125b-5p was decreased 0.35 fold in CHE but not in AHE patients. Furthermore, decreased miR-122-5p expression significantly correlates with reduced liver transaminases in CHE patients. To our knowledge, this marks the first investigation concerning the regulation of circulating liver-specific miRNAs in acute and chronic HEV infections. We found that miR-125b-5p, miR-192-5p, and miR-99a-5p may prove useful in the diagnosis of chronic hepatitis E.

Highlights

  • Hepatitis E virus (HEV) genotypes 3 and 4 (HEV-3, HEV-4) infections are an emerging public health issue in industrialized countries

  • All 38 patient samples included were analyzed for virus load andgenotype using HEV-specific real-time quantitative PCR (qPCR) and nested RT-PCR followed by Sanger sequencing and phylogenetic analyses

  • AHEv and CHEv serum samples were found to be viremic with a median viral load of 3.23E + 05 IU/ml serum (1.44E + 04 to 8.15E + 06 IU/ml) and 2.11E + 06 IU/ml (1.29E + 04 to 7.27E + 06 IU/ml), respectively

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Summary

Introduction

Hepatitis E virus (HEV) genotypes 3 and 4 (HEV-3, HEV-4) infections are an emerging public health issue in industrialized countries. We aimed to explore the modulation of serum miRNAs in patients with acute (AHE) and chronic (CHE) hepatitis E. Decreased miR-122-5p expression significantly correlates with reduced liver transaminases in CHE patients To our knowledge, this marks the first investigation concerning the regulation of circulating liver-specific miRNAs in acute and chronic HEV infections. Infections in immunocompetent patients usually remain asymptomatic or present as a mild and self-limiting viral hepatitis without lasting damage Serious complications such as fulminant hepatic failure can occur in patients with pre-existing liver disease while increased fetal and maternal mortality rates are reported in infected pregnant women[5,6]. A number of miRNAs including miR-99a, miR-122, and miR-125b were found to be upregulated in patients with hepatitis B virus (HBV) infection and expression levels allowed differentiation between HBV, hepatitis C virus (HCV) and HBV-related hepatocellular carcinoma[24,25,26,27]. Increased serum miR-122 levels are predictive for enhanced inflammation in chronic HCV patients[29,30]

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