Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritis

Abstract Introduction Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune necrotizing small vessel vasculitis, frequently resulting in severe renal manifestations such as rapidly progressive glomerulonephritis (AAV-GN). Monitoring disease activity and determining ongoi...

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Main Authors: Matic Bošnjak, Željka Večerić-Haler, Živa Pipan Tkalec, Emanuela Boštjančič, Nika Kojc
Format: Article
Language:English
Published: BMC 2025-07-01
Series:European Journal of Medical Research
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Online Access:https://doi.org/10.1186/s40001-025-02905-9
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author Matic Bošnjak
Željka Večerić-Haler
Živa Pipan Tkalec
Emanuela Boštjančič
Nika Kojc
author_facet Matic Bošnjak
Željka Večerić-Haler
Živa Pipan Tkalec
Emanuela Boštjančič
Nika Kojc
author_sort Matic Bošnjak
collection DOAJ
description Abstract Introduction Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune necrotizing small vessel vasculitis, frequently resulting in severe renal manifestations such as rapidly progressive glomerulonephritis (AAV-GN). Monitoring disease activity and determining ongoing renal involvement remain significant clinical challenges due to the limitations associated with traditional biomarkers. This study focused on the potential of circulating microRNA (miRNA) as supplementary noninvasive biomarkers for disease activity in AAV-GN. Methods This prospective follow-up study involved serum samples from 60 patients with biopsy-proven AAV-GN, collected at renal biopsy and at 3-, 6-, 12-, and 24-month intervals post-biopsy. Nine miRNAs (miR-21-3p, miR-30b/d/e-5p, miR-142-5p, miR-150-5p, miR-181a-5p, miR-181b-5p, and let-7a-5p) were selected based on the differential expressions in renal tissue and corresponding serum samples identified in the previous research phases. Expression analysis was performed using quantitative real-time polymerase chain reaction and correlated with disease activity based on the Birmingham Vasculitis Activity Score and other clinical parameters. Results A significant correlation was identified between disease activity and the expression levels of the miR-30 family members and let-7a. Specifically, these miRNAs demonstrated consistent correlation patterns across follow-up samples independent of the time elapsed post-biopsy, with down-regulation correlating with the presence of active disease. Notably, the miRNA expression profile in partial remission appeared analogous to that of complete remission, suggesting that many patients categorized as having partial remission may, in fact, be considered in true clinical remission. Conclusion This study supports serum miRNA profiling as an adjunct noninvasive biomarker for assessing disease activity in AAV-GN. Such an approach could provide complementary information alongside traditional biomarkers and refine the future management of AAV-GN. However, it is important to acknowledge that our actual study cohort was small due to challenging technical aspects of miRNA expression analysis in the serum. Therefore, further research with larger cohorts is required to validate these results and assess their clinical applicability.
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spelling doaj-art-aef0fc8f0413486596ebc8a267ac27cf2025-08-20T03:45:51ZengBMCEuropean Journal of Medical Research2047-783X2025-07-0130111010.1186/s40001-025-02905-9Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritisMatic Bošnjak0Željka Večerić-Haler1Živa Pipan Tkalec2Emanuela Boštjančič3Nika Kojc4Institute of Pathology, Faculty of Medicine, University of LjubljanaDepartment of Nephrology, University Medical Centre LjubljanaInstitute of Pathology, Faculty of Medicine, University of LjubljanaInstitute of Pathology, Faculty of Medicine, University of LjubljanaInstitute of Pathology, Faculty of Medicine, University of LjubljanaAbstract Introduction Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis is an autoimmune necrotizing small vessel vasculitis, frequently resulting in severe renal manifestations such as rapidly progressive glomerulonephritis (AAV-GN). Monitoring disease activity and determining ongoing renal involvement remain significant clinical challenges due to the limitations associated with traditional biomarkers. This study focused on the potential of circulating microRNA (miRNA) as supplementary noninvasive biomarkers for disease activity in AAV-GN. Methods This prospective follow-up study involved serum samples from 60 patients with biopsy-proven AAV-GN, collected at renal biopsy and at 3-, 6-, 12-, and 24-month intervals post-biopsy. Nine miRNAs (miR-21-3p, miR-30b/d/e-5p, miR-142-5p, miR-150-5p, miR-181a-5p, miR-181b-5p, and let-7a-5p) were selected based on the differential expressions in renal tissue and corresponding serum samples identified in the previous research phases. Expression analysis was performed using quantitative real-time polymerase chain reaction and correlated with disease activity based on the Birmingham Vasculitis Activity Score and other clinical parameters. Results A significant correlation was identified between disease activity and the expression levels of the miR-30 family members and let-7a. Specifically, these miRNAs demonstrated consistent correlation patterns across follow-up samples independent of the time elapsed post-biopsy, with down-regulation correlating with the presence of active disease. Notably, the miRNA expression profile in partial remission appeared analogous to that of complete remission, suggesting that many patients categorized as having partial remission may, in fact, be considered in true clinical remission. Conclusion This study supports serum miRNA profiling as an adjunct noninvasive biomarker for assessing disease activity in AAV-GN. Such an approach could provide complementary information alongside traditional biomarkers and refine the future management of AAV-GN. However, it is important to acknowledge that our actual study cohort was small due to challenging technical aspects of miRNA expression analysis in the serum. Therefore, further research with larger cohorts is required to validate these results and assess their clinical applicability.https://doi.org/10.1186/s40001-025-02905-9ANCAVasculitisGlomerulonephritisMicroRNABiomarkerBVAS
spellingShingle Matic Bošnjak
Željka Večerić-Haler
Živa Pipan Tkalec
Emanuela Boštjančič
Nika Kojc
Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritis
European Journal of Medical Research
ANCA
Vasculitis
Glomerulonephritis
MicroRNA
Biomarker
BVAS
title Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritis
title_full Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritis
title_fullStr Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritis
title_full_unstemmed Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritis
title_short Circulating miRNAs correlate with clinical evaluation of activity in ANCA-associated glomerulonephritis
title_sort circulating mirnas correlate with clinical evaluation of activity in anca associated glomerulonephritis
topic ANCA
Vasculitis
Glomerulonephritis
MicroRNA
Biomarker
BVAS
url https://doi.org/10.1186/s40001-025-02905-9
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AT zivapipantkalec circulatingmirnascorrelatewithclinicalevaluationofactivityinancaassociatedglomerulonephritis
AT emanuelabostjancic circulatingmirnascorrelatewithclinicalevaluationofactivityinancaassociatedglomerulonephritis
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