IDENTIFICATION OF PLASMATIC MICRORNAS ASSOCIATED WITH PULMONARY EMBOLISM IN PATIENTS WITH ACUTE-ONSET DYSPNEA - PILOT RESULTS

Introduction: Acute-onset dyspnea represents one of the most common reasons for evaluation of the patient at the emergency departments. Differential diagnostics of acute-onset dyspnea requires thorough physical and paraclinical examination. To establish the diagnosis of pulmonary embolism (PE), there is currently no enough sensitive and specific biomarker and diagnosis needs to be confirmed by CT pulmonary angiography (CTPA). Circulating microRNAs (miRNAs, miRs) represents an intriguing group of biomarkers that were shown to be altered between healthy individuals and PE patients. Aim of the current study was to identify miRNAs distinguishing dyspneic patients with and without PE.
Methods: 28 consecutive patients with acute onset dyspnea suspected of having PE based on clinical exam and lab testing were enrolled. Patients underwent CTPA to confirm (n = 17) or exclude (n= 11) PE. Prior CTPA, all patients signed informed consent and then underwent blood sampling into EDTA tubes. Plasma was separated and total RNA was isolated using miRNeasy Serum/Plasma Kit®. Seven samples were used for next-generation sequencing on Illumina NextSeq 550 (n=4 CTPA-confirmed PE and n=3 CTPA-excluded PE). Sequencing data were analyzed in R with DESeq2 and EdgeR packages.
Results: 975 miRNAs were identified in the plasmatic samples. Levels of 50 miRNAs were shown to be altered between patients w/o PE (unadjusted p-value < 0.05). Out of these, five miRNAs presented total number of reads > 200 and the fold change > 0.5, which makes them potential PE biomarkers: miR-155-5p, -625-3p, -7-5p, -29a-3p, and -361-3p.
Conclusion: We have identified a group of 5 plasmatic miRNAs whose levels differ between patients with acute onset dyspnea with CTPA confirmed or excluded PE. Validation on independent large set of patients is now pending to confirm their potential diagnostic utility.