The expression level and clinical significance of serum miR-451a in patients with pulmonary tuberculosis

ZHAO Yong; LIANG Li-li; JIANG Nan

doi:10.13820/j.cnki.gdyx.20231212

Abstract：Objective To investigate the correlations of serum microRNA(miR)-451a and Toll-like receptor 4(TLR4)expression levels with the prognosis of patients with active pulmonary tuberculosis(ATB).Methods A total of 350 patients with pulmonary tuberculosis were classified based on their diagnostic status into ATB group(162 cases)and non-ATB(NATB)group(188 cases).Additionally,180 healthy individuals undergoing physical examinations were included as the control group.The ATB group was further divided into favorable prognosis group(120 cases)and unfavor-able prognosis group(42 cases)based on their prognosis.Serum levels of miR-451a and TLR4 mRNA were measured,and factors influencing the prognosis of ATB patients were analyzed.The Pearson method was used to analyze the correla-tion between miR-451a and TLR4 mRNA.Receiver operating characteristic(ROC)curves were drawn to assess the pre-dictive efficacy of serum miR-451a and TLR4 mRNA for the prognosis of ATB patients.Results The serum levels of miR-451a in the control group,NATB group,and ATB group decreased successively,while TLR4 mRNA levels in-creased(all P＜0.05).There was a negative correlation between serum miR-451 a and TLR4 mRNA levels in ATB pa-tients(r=-0.519,P＜0.05).Serum miR-451 a was negatively correlated with C-reactive protein(CRP),erythro-cyte sedimentation rate(ESR),interferon-γ(IFN-γ),and interleukin-12(IL-12)(r=-0.404,-0.377,-0.435,-0.391,P＜0.05),while serum TLR4 mRNA was positively correlated with CRP,ESR,IFN-γ,and IL-12(r=0.469,0.361,0.442,0.384,P＜0.05).The serum miR-451a level were lower in the unfavorable prognosis group than that in the favorable prognosis group,while serum TLR4 mRNA level were higher in the unfavorable prognosis group(P＜0.05).Regression analysis showed that TLR4 mRNA and miR-451a were factors influencing the prognosis of ATB patients(P=0.001,0.009).The combined predictive efficacy of serum miR-451a and TLR4 mRNA for unfavor-able prognosis in ATB patients was AUC=0.949,which was superior to the individual detection of miR-451a(AUC=0.852)and TLR4 mRNA(AUC=0.821)(P＜0.05).Conclusion In ATB patients,the serum levels of miR-451 a decrease while TLR4 mRNA levels increase,and these levels are closely associated with inflammation and prognosis.The combined detection of miR-451a and TLR4 mRNA has higher predictive value for prognosis.