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Abstract
Dysregulation of miRNAs has been described in systemic lupus erythematosus (SLE); however the clinical relevance of using miRNAs as biomarkers for SLE or predictors of disease progression is poorly investigated. This study investigated the expression signature of plasma miR-21, miR-181a and miR-196a among seventy SLE patients with different systemic lupus erythematosus disease activity index (SLEDAI) scores and thirty healthy controls using quantitative real-time PCR. Plasma interleukin-10 (IL-10) level was also measured in plasma of patients and control subjects. The expression levels of all selected miRNAs were significantly increased in SLE patients as compared to healthy controls. These miRNAs could also discriminate mild patients from severe patients by receiver operating characteristic (ROC) analysis. miR-196a was superior to differentiate patients from controls, whereas miR-21 was superior to discriminate mild patients from severe patients. Multivariate logistic analysis revealed miR-196a as independent predictor SLE diagnosis, it also suggests the strength of miR- 21 and miR-196a as predictive biomarkers for development of SLE from mild form to severe form. Plasma IL-10 level was higher in SLE patients as compared to control subjects but it was not correlated with disease activity. However; IL-10 showed a significant correlation with miR-21 expression. In conclusion, these miRNAs represent potential biomarkers in SLE. miR-21 could serve as predictor of disease progression, while miR-196a emerges as a novel valuable biomarker to predict both SLE risk and progression. This could be a critical tool for personalizing therapy to avoid irreversible organ damage associated with SLE