BACKGROUND Extracellular microRNAs (miRNAs), released from cells into biofluids, have emerged as promising biomarkers for diagnostic and prognostic purposes. For the analysis of these cell-free miRNAs in various biofluids by RT-qPCR, several RNA isolation methods are available. However, not all methods are equally suitable for different biofluids. The aim of this study is to evaluate the potential of different RNA isolation methods in a range of clinical biofluid samples.METHODS Total RNA was isolated from serum, urine, bile, and graft preservation fluid (perfusate) using four different protocols: phenol-chloroform extraction in combination with a precipitation carrier, and three different column-based isolation methods. Co-purification of heparin, a known RT-qPCR inhibitor, was assessed using heparinase I during cDNA synthesis. Synthetic miRNAs, spiked-in during RNA workup (cel-miR-39) or during cDNA synthesis (cel-miR-54), and endogenous miRNAs were quantified using RT-qPCR.RESULTS Recovery of cel-miR-39 significantly differed between methods with miRNeasy columns providing the best overall recovery in the four biofluids tested, as was also observed for endogenous miRNAs. Contamination of RNA with heparin differed between sample type and isolation method, and could be counteracted using heparinase I. Other co-isolated RT-qPCR inhibitors were not identified, except for biliverdin which co-isolated from some bile samples with one of the methods.CONCLUSIONS For reliable measurements of miRNA-based biomarkers in biofluids, optimization of RNA isolation procedures is recommended as methods can differ in miRNA detection and co-purification of RT-qPCR inhibitory compounds. Heparinase I treatment confirmed that heparin appeared to be the major RT-qPCR-inhibiting compound but also biliverdin, co-isolated from bile, could interfere with detection.
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