The Clinical Value of Exosome miRNA-135-5p to Myocardial Injury Degree and Prognosis in Children with Viral Myocarditis by Inhibiting AKT/mTOR Signal Pathway
Objective:To analyze the serum levels of exosome miRNA-135-5p in children with viral myocarditis,and to evaluate its clinical value to the myocardial injury degree and prognosis by inhibiting AKT/mTOR signal pathway.Methods:The 50 children with viral myocarditis in our hospital were collected and divided into the two groups according to the degree of viral myocarditis,which were severe group(15 cases)and mild group(35 cases).The 30 healthy examinees were collected to control group.The serum levels of exo-some miRNA-135-5p,AKT mRNA and mTOR mRNA were detected by reverse transcription-polymerase chain reaction(RT-PCR)and compared among 3 groups.The correlations of exosome miRNA-135-5p to serum AKT mRNA and mTOR mRNA were confirmed by Pearson linear correlation analysis.The risk factors of illness degree of children with viral myocarditis to the clinical indexes were con-firmed by multivariate Logistic analysis.Follow-up 12 months,the diagnostic value of exosome miRNA-135-5p to the 12 months fol-low-up prognosis of the children with viral myocarditis were analyzed by receiver operating characteristic curves(ROC).Results:Com-pared to control group,the serum levels of exosome miRNA-135-5p in severe group and mild group were higher,and severe group high-er than mild group(P＜0.05).The serum levels of AKT,mTOR mRNA in severe group and mild group were lower than control group,and severe group lower than mild group(P＜0.05).The negative correlations of exosome miRNA-135-5p to serum AKT mRNA and mTOR mRNA were confirmed by Pearson linear correlation analysis(P＜0.05).Multivariate Logistic analysis showed that the serum levels of exosome miRNA-135-5p were independent risk factors to the 12 months follow-up prognosis of children with viral myocarditis,but the levels of AKT mRNA and mTOR mRNA were the protective factors(P＜0.05).When the cut-off point of exosome miRNA-135-5p was 3.32,the AUC was 0.822 and the sensitivity was 86.3％and specificity was 80.6％.Conclusions:The serum levels of exosome miR-NA-135-5p is the risk factor to the myocardial injury degree in children with viral myocarditis by inhibiting AKT/mTOR signal pathway,and can perfect assess the 6 months follow-up prognosis.
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