Value of cystic fluid exosomes-derived microRNAs in differential diagnosis of autosomal dominant polycystic kidney disease and simple renal cystic patients
Objective To explore the value of cystic fluid exosomes-derived microRNAs in identifying of ADPKD and SRC patients.Methods Twenty newly diagnosed ADPKD patients admitted to the First Affiliated Hospital of Xinxiang Medical University from January 2019 to January 2021 were selected as the experimental group(ADPKD group).20 pa-tients with age-gender matched simple renal cystic(SRC)during the same period were selected as the control group(SRC group).Renal cyst aspiration was performed after exclusion of relevant contraindications.Cyst fluid exosomes were isolated and extracted.Six patients in each group were randomly selected for high-throughput microRNA sequencing to compare the differences between the groups,and real-time fluorescence quantitative PCR(qRT-PCR)was used to verify the sequencing results.The remaining 14 patients in each group were used as a validation cohort to evaluate the value of differentially expressed microRNAs in the differential diagnosis of ADPKD and SRC by receiver-operating characteristic curve(ROC).Results There was no significant difference in gender,age,creatinine and hemoglobin levels between the two groups(P＞0.05).The results of high throughput sequencing showed that there were 18 differentially expressed microRNA between ADPKD group and SRC group.Compared with the SRC group,9 microRNA were up-regulated and 9 microRNA were down-regulated in the ADPKD group.Bioinformatics analysis results predicted that significantly up-regulated microRNA were mainly involved in proximal tubule bicarbonate reclamation pathway,glutamate metabolism and pluripotency of stem cells regulating path-ways.Down-regulated microRNA might participate in MAPK signaling pathway and cell adhesion pathway.The expres-sion changes of miR-1291 and miR-6852-5p between groups verified by qRT-PCR were consistent with the se-quencing results(P＜0.05).The results of ROC curve showed the miR-1291(AUC=0.73)and miR-6852-5p(AUC=0.84)may have the potential to discriminate between ADPKD and SRC.Combined testing of two indicators may improves effectiveness(AUC=0.91).Conclusion Cystic fluid exosomes-derived microRNAs profiles were changed in ADPKD patients.Of them,miR-1291and miR-6852-5p are expected to be biomarkers for the identification of ADPKD and SRC.
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