Expression levels of peripheral exosomal miR-21 and miR-574 and their clinical significances in monitoring acute exacerbation of chronic obstructive pulmonary disease

HUANG Yao; SHI Guoqiang

doi:10.3969/j.issn.1002-7386.2025.02.007

Abstract：Objective To investigate the value of peripheral exosomal miR-21 and miR-574 in monitoring acute exacerbation of chronic obstructive pulmonary disease(AECOPD)by detecting their expressions in different phases of COPD.Methods A total of 40 AECOPD patients admitted in the Respiratory Department of Taikang Xianlin Drum Tower Hospital from March 2021 to December 2022 were recruited.After treatment,they were improved and selected in the stable COPD(SCOPD)group.Forty healthy volunteers were recruited as the control group during the same period.Serum exosomes were isolated and extracted from peripheral blood,and their morphology was observed under an electron microscope.The particle size and expression level of exosomes were measured by the NanoSight analyzer.Protein expressions of exosome markers were measured by Western Blot.The mRNA levels of exosomal miR-21 and miR-574 were measured by reverse transcription quantitative PCR(RT-qPCR).Spearman correlation coefficient analysis was used to evaluate the correlation of exosomal miR-21 and miR-574 with other variables.Receiver operating characteristic(ROC)curve was used to evaluate the reliability of exosomal miR-21 and miR-574 as specific biomarkers for the diagnosis of COPD.Results Compared with healthy control group,exosomal miR-21 and miR-574 were significantly upregulated in the AECOPD group(P＜0.01).After treatment,exosomal miR-21 and miR-574 in SCOPD patients were reduced to varying degrees(P＜0.05).Correlation analysis showed that peripheral exosomal miR-21 and miR-574 levels positively correlated with the inflammatory indicators,including the white blood cell count(WBC),absolute neutrophil count(ANC),neutrophil-to-lymphocyte ratio(NLR),C-reactive protein(CRP),interleukin-1 β(IL-1β),interleukin-6(IL-6),and tumor necrosis factor-α(TNF-α).In the differential diagnosis of AECOPD from healthy controls,the area under the curve(AUC)of exosomal miR-21,exosomal miR-574 and their combination was 0.811,0.751,and 0.850,respectively.Conclusion Peripheral levels of exosomal miR-21 and miR-574 are significantly correlated with the inflammatory state of COPD patients,showing a potential in identifying AECOPD.