CircRNA-0004904, CircRNA-0001855, and PAPP-A: Potential Novel Biomarkers for the Prediction of Preeclampsia

Abstract

Background/Aims: Circular RNAs (circRNAs) are transcribed prevalently in the genome; however, their potential roles in multiple cardiovascular diseases, particularly preeclampsia (PE), are not yet well understood. This study investigated the expression profiles of circRNAs and explored circRNA-mediated pregnancy-associated plasma protein A (PAPP-A) expression as a potential biomarker for PE before 20 weeks of pregnancy. Methods: A nested case-control two-phase screening/validation study was performed in pregnant women before 20 weeks of gestation (before clinical diagnosis) at Guangzhou Women and Children’s Medical Center from 2012 to 2015. In the screening phase, circRNA expression profiles of blood cells were assessed using a human circRNA microarray, which was designed to detect simultaneously 5396 circRNAs, in 5 patients with PE and 5 age- and gestational week-matched controls. In the validation phase, 18 circRNAs in blood cells predicted by bioinformatics tools were validated by quantitative reverse transcription PCR in a cohort of 60 patients (PE and age-, gestational week-, and sample storage time-matched controls). Then, we examined the involvement of circRNAs in PE-related pathways via interactions with miRNAs by multiple bioinformatics approaches. Bioinformatics analysis predicted that hsa_circ_0004904 and hsa_circ_0001855 miRNA sponges directly target PAPP-A. PAPP-A was verified in the serum of the same cohort of patients using an enzyme-linked immunosorbent assay. Finally, we combined PAPP-A with circRNAs to create a novel preclinical diagnostic model for PE with logistic regression and evaluated the efficiency of this model with receiver operating curve analysis. Results: Volcano plot analysis using various parameters showed that circRNAs were differentially expressed among both groups (P < 0.01, fold change > 2). In the screening phase, we found that 2178 circRNAs were differentially expressed between the control and PE groups, in which 884 circRNAs were downregulated and 1294 circRNAs were upregulated in the PE group compared with the control group. In the validation phase, two circRNAs, hsa_circ_0004904 and hsa_circ_0001855, were significantly upregulated in PE patients compared with healthy pregnant women (P < 0.05). PAPP-A expression levels, related to the two circRNAs based on bioinformatics prediction, were increased in the PE group compared with the control group. The area under the curve of the combined model was 0.94 in the predicted PE subjects. Conclusions: This is the first study to report circRNA profiling in patients with PE prior to the onset of symptoms. Our data suggested that hsa_circ_0004904 and hsa_circ_0001855 combined with PAPP-A might be promising biomarkers for the detection of PE. Moreover, circRNAs may provide new insights into the potential mechanisms underlying the pathophysiology of PE.

Down-regulated circPAPPA suppresses the proliferation and invasion of trophoblast cells via the miR-384/STAT3 pathway

“…Studies on PE and circRNAs are still in the preliminary stages, but in a recent report, differential circRNA expression profiles were observed in blood and placenta tissues of PE patients [11,25]. Using clinical correlation studies, some differentially expressed circRNAs, such as hsa circ 0036877, circRNA-0004904, and circRNA-0001855, might function as competing endogenous RNAs and serve as novel blood biomarkers for the early prediction of PE [26,27]. In the present study, we evaluated the possible functions of a circRNA, circPAPPA, which we previously characterized.…”

Could circRNA be a new biomarker for pre‐eclampsia?

“…According to previous evidence, low levels of PAPP‐A have been documented in the serum of pre‐eclampsic women (Jiang et al, ). There are evidence demonstrating the existence of PAPP‐A in the serum of pre‐eclampsic women (Jiang et al, ). Taken together, the above data indicates that circRNAs are differently expressed in pre‐eclampsia which provides new insight into the novel biomarkers for the prediction of pre‐eclampsia.…”

“…Recently, a bioinformatic analysis reported hsa_circ_0004904 and hsa_circ_0001855 as the two biomarkers involved in the pathogenesis of pre-eclampsia, through activating miRNA sponges which directly target pregnancy-associated plasma protein-A (PAPP-A). According to previous evidence, low levels of PAPP-A have been documented in the serum of pre-eclampsic women (Jiang et al, 2018). There are evidence demonstrating the existence of PAPP-A in the serum of pre-eclampsic women (Jiang et al, 2018).…”

“…One of the main functions of circRNAs is the activation of miRNA sponge which is involved in the pathogenesis of several diseases. On the other hand, some studies have suggested that circRNAs might play an important role in the pathogenesis of pre‐eclampsia through activating miRNA sponge method (Jiang et al, ; Qian et al, ; Zhou et al, ). Thus, we hypothesize that alterations in the levels of circRNAs may be involved in the pathogenesis of pre‐eclampsia and associated with its incidence.…”

Circular RNA Expression Profiles in Plasma from Patients with Heart Failure Related to Platelet Activity

“…In recent years, many circRNAs have been identified via high-throughput sequencing and bioinformatics analyses. CircRNAs, which are abundant and stably present in organisms, have become a focus of extensive research [21,22]. CircRNAs can modulate alternative splicing, transcription, and the expression of parental genes; one of the regulatory pathways involves microRNA (miRNA) sponges [23][24][25].…”