Circulating microRNAs as Non-Invasive Biomarkers in Endometriosis Diagnosis—A Systematic Review

Abstract

The aim of this systematic review is to assess the power of circulating miRNAs as biomarkers as a diagnostic tool in endometriosis. In endometriosis-suspected women with uncertain imaging, the only way to confirm or exclude endometriosis with certainty is currently laparoscopy. This creates a need for non-invasive diagnostics. We searched the literature through the PubMed database using the Mesh terms ‘endometriosis’ and ‘miRNAs’. Some, but limited, overlap was found between the 32 articles included, with a total of 20 miRNAs reported as dysregulated in endometriosis in two or more studies. MiR-17-5p was reported as dysregulated in six studies, followed by miR-451a and let-7b-5p in four studies and miR-20a-5p, miR-143-3p, miR-199a-5p and miR-3613-5p in three studies. Furthermore, a possible impact of the menstrual phase on miRNA expression was noted in five studies, while no influence of hormonal intake was observed in any included study. The modest reproducibility between studies may be attributable to biological variability as well as to the lack of universal protocols, resulting in pre- and analytical variability. Despite the identification of several suitable candidate biomarkers among the miRNAs, the need for high-quality studies with larger and well-defined population cohorts and the use of standardized protocols lingers.

Endometriosis: Improvements and challenges in diagnosis and symptom management

“…These studies reported 141 miRNAs as differentially expressed, although there was considerable variation and only has-miR-17-5p was reported in 6 (19%) studies. 10 In other studies, investigators have analyzed 200 saliva samples collected as part of a prospective clinical trial (ENDO-miRNA study ( ClinicalTrials.gov identifier: NCT04728152). Their analysis was based on a panel of 109 miRNAs as a biomarker test for endometriosis, and they reported that this test had predictive value, specificity, and sensitivity all greater than 95%.…”