Circulating miRNA-21-5p as a Biomarker for Predicting Clinical Outcomes in Decompensated Liver Cirrhosis: Insights from Large Patient Cohort

Chronic liver diseases, particularly cirrhosis, impose a substantial healthcare burden globally, characterized by high morbidity and mortality rates. Decompensated cirrhosis frequently progresses to acute-on-chronic liver failure (ACLF), marked by multi-organ dysfunction and elevated 28-day mortality. Accurate prediction of ACLF progression is critical for optimizing patient care. This study focuses on the potential of circulating microRNAs (miRNAs) as biomarkers for advanced liver disease, with a specific emphasis on ACLF.

First, in a pilot study representative patient groups, including ACLF, decompensated cirrhosis, and compensated cirrhosis, miRNA sequencing unveiled notable variations between ACLF patients and controls. Especially, miRNA-21-5p exhibited a substantial increase in ACLF patients. The validation process was carried out in two extensive patient cohorts, namely, ACLARA (n=522) and PREDICT (n=722). miRNA-21-5p significantly correlated with markers of liver function in these large patient cohorts. Furthermore, high serum levels of miRNA-21-5p were associated with unfavorable clinical outcomes, including decreased 90-day survival.

These findings collectively suggest that miRNA-21-5p has the potential to serve as a reliable predictor of clinical outcomes and resource utilization in patients with decompensated liver cirrhosis. While these results hold promise, additional research is warranted to gain a more comprehensive understanding of the molecular mechanisms and clinical implications linked to altered miRNA-21-5p serum levels.

Publication History

Article published online:
23 January 2024