The relationship between the expression of serum microRNA-330-5p and Toll-like receptor 4 and neuroin-flammatory response and prognosis in children with status epilepticus

Jin Xin; Zhang Xiaodong; Wu Song

doi:10.3760/j.issn.1673-4777.2025.07.008

Abstract：Objective To investigate the relationship between the expression of serum microRNA(miR)-330-5p and Toll-like receptor 4(TLR4)and neuroinflammatory response and prognosis in children with status epilepticus(SE).Methods A total of 98 children with SE admitted to 3201 Hospital from January 2021 to November 2023 were selected as the SE group.According to the prognosis 28 days after admission,they were divided into poor prognosis group(37 cases)and good prognosis group(61 cases),and 40 healthy children in the same period were selected as the control group.The levels of serum miR-330-5p,TLR4 and neuroinflammatory markers[interleukin 1 β(IL-1β),IL-6 and tumor necrosis factor α(TNF-α)]were detected.The binding sites of miR-330-5p and TLR4 were predicted by online websites.The correlation between serum miR-330-5p and TLR4 was analyzed by Pearson correlation coefficient.The prognosis of children with SE was used as the dependent variable,and multivariate Logistic regression analysis was used to determine the influencing factors.The receiver operating characteristic curve was used to analyze the predictive value of serum miR-330-5p and TLR4 in the poor prognosis of children with SE.Results Compared with the control group,the expression of serum miR-330-5p in the SE group was decreased,and the expressions of TLR4,IL-1β,IL-6 and TNF-α were increased(all P＜0.001).There was a binding site between miR-330-5p and TLR4 3′-untranslated region 5310-5317.The expression of serum miR-330-5p was negatively correlated with the expression of TLR4,IL-1β,IL-6,TNF-α in children with SE(r=-0.686,-0.672,-0.646,-0.687,all P＜0.001),the expression of TLR4 was positively correlated with the expression of IL-1β,IL-6 and TNF-α(r=0.711,0.679,0.701,all P＜0.001).The onset time of SE≥1 h[odds ratio(OR)=4.317,95％confidence interval(CI):1.011 to 18.435],the increased severity score of SE(OR=2.749,95％CI:1.392 to 5.428),and the increased levels of IL-1 β(OR=1.067,95％CI:1.010 to 1.127),IL-6(OR=1.137,95％CI:1.014 to 1.275),TNF-α(OR=1.343,95％CI:1.051 to 1.716)and TLR4(OR=2.375,95％CI:1.133 to 4.978)were independent risk factors for poor prognosis of SE children,and the increased level of miR-330-5p was an independent protective factor(OR=0.933,95％CI:0.888 to 0.980)(all P＜0.05).The area under the curve(AUC)of serum miR-330-5p and TLR4 expression alone and in combination for predicting poor prognosis in children with SE were 0.794(95％CI:0.700 to 0.869),0.797(95％CI:0.703 to 0.871),and 0.881(95％CI:0.800 to 0.938)in order,and the binomial joint prediction AUC was the largest(both P＜0.05).Conclusion Low expression of serum miR-330-5p and high expression of TLR4 are closely related to increased neuroinflammation and poor prognosis in children with SE.The combination of serum miR-330-5p and TLR4 has a high predictive value for poor prognosis in children with SE.