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The Serum Cell-Free microRNA Expression Profile in MCTD, SLE, SSc, and RA Patients

Identifieur interne : 000E29 ( Ncbi/Merge ); précédent : 000E28; suivant : 000E30

The Serum Cell-Free microRNA Expression Profile in MCTD, SLE, SSc, and RA Patients

Auteurs : Barbara Stypinska [Pologne] ; Anna Wajda [Pologne] ; Ewa Walczuk [Pologne] ; Marzena Olesinska [Pologne] ; Aleksandra Lewandowska [Pologne] ; Marcela Walczyk [Pologne] ; Agnieszka Paradowska-Gorycka [Pologne]

Source :

RBID : PMC:7020053

Abstract

Mixed connective tissue disease (MCTD) is a rare disorder characterized by symptoms that overlap two or more Autoimmune Connective Tissue Diseases (ACTDs). The aim of this study was to determine whether miRNAs participating in the TLRs signaling pathway could serve as biomarkers differentiating MCTD or other ACTD entities from a healthy control group and between groups of patients. Although the selected miRNA expression level was not significantly different between MCTD and control, we observed that miR-126 distinguishes MCTD patients from all other ACTD groups. The expression level of miRNAs was significantly higher in the serum of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients compared to controls. The miR-145 and -181a levels distinguished RA from other ACDT patients. miR-155 was specific for SLE patients. MiR-132, miR-143, and miR-29a distinguished RA and SLE patients from the systemic sclerosis (SSc) group. Additionally, some clinical parameters were significantly related to the miRNA expression profile in the SLE group. SLE and RA are characterized by a specific serum expression profile of the microRNAs associated with the Toll-like receptors (TLRs) signaling pathway. The analysis showed that their level distinguishes these groups from the control and from other ACTD patients. The present study did not reveal a good biomarker for MCTD patients.


Url:
DOI: 10.3390/jcm9010161
PubMed: 31936082
PubMed Central: 7020053

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PMC:7020053

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<p>Mixed connective tissue disease (MCTD) is a rare disorder characterized by symptoms that overlap two or more Autoimmune Connective Tissue Diseases (ACTDs). The aim of this study was to determine whether miRNAs participating in the TLRs signaling pathway could serve as biomarkers differentiating MCTD or other ACTD entities from a healthy control group and between groups of patients. Although the selected miRNA expression level was not significantly different between MCTD and control, we observed that miR-126 distinguishes MCTD patients from all other ACTD groups. The expression level of miRNAs was significantly higher in the serum of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients compared to controls. The miR-145 and -181a levels distinguished RA from other ACDT patients. miR-155 was specific for SLE patients. MiR-132, miR-143, and miR-29a distinguished RA and SLE patients from the systemic sclerosis (SSc) group. Additionally, some clinical parameters were significantly related to the miRNA expression profile in the SLE group. SLE and RA are characterized by a specific serum expression profile of the microRNAs associated with the Toll-like receptors (TLRs) signaling pathway. The analysis showed that their level distinguishes these groups from the control and from other ACTD patients. The present study did not reveal a good biomarker for MCTD patients.</p>
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<journal-id journal-id-type="nlm-ta">J Clin Med</journal-id>
<journal-id journal-id-type="iso-abbrev">J Clin Med</journal-id>
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<article-id pub-id-type="pmc">7020053</article-id>
<article-id pub-id-type="doi">10.3390/jcm9010161</article-id>
<article-id pub-id-type="publisher-id">jcm-09-00161</article-id>
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<contrib contrib-type="author">
<contrib-id contrib-id-type="orcid" authenticated="true">https://orcid.org/0000-0002-4249-3136</contrib-id>
<name>
<surname>Paradowska-Gorycka</surname>
<given-names>Agnieszka</given-names>
</name>
<xref ref-type="aff" rid="af1-jcm-09-00161">1</xref>
</contrib>
</contrib-group>
<aff id="af1-jcm-09-00161">
<label>1</label>
Department of Molecular Biology, National Institute of Geriatrics, Rheumatology, and Rehabilitation, 02-637 Warsaw, Poland</aff>
<aff id="af2-jcm-09-00161">
<label>2</label>
Department of Connective Tissue Diseases, National Institute of Geriatrics, Rheumatology, and Rehabilitation, 02-637 Warsaw, Poland</aff>
<author-notes>
<corresp id="c1-jcm-09-00161">
<label>*</label>
Correspondence:
<email>barbara.stypinska@wp.pl</email>
; Tel.: +22-646-39-96 (ext. 181)</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>07</day>
<month>1</month>
<year>2020</year>
</pub-date>
<pub-date pub-type="collection">
<month>1</month>
<year>2020</year>
</pub-date>
<volume>9</volume>
<issue>1</issue>
<elocation-id>161</elocation-id>
<history>
<date date-type="received">
<day>01</day>
<month>12</month>
<year>2019</year>
</date>
<date date-type="accepted">
<day>03</day>
<month>1</month>
<year>2020</year>
</date>
</history>
<permissions>
<copyright-statement>© 2020 by the authors.</copyright-statement>
<copyright-year>2020</copyright-year>
<license license-type="open-access">
<license-p>Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (
<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>
).</license-p>
</license>
</permissions>
<abstract>
<p>Mixed connective tissue disease (MCTD) is a rare disorder characterized by symptoms that overlap two or more Autoimmune Connective Tissue Diseases (ACTDs). The aim of this study was to determine whether miRNAs participating in the TLRs signaling pathway could serve as biomarkers differentiating MCTD or other ACTD entities from a healthy control group and between groups of patients. Although the selected miRNA expression level was not significantly different between MCTD and control, we observed that miR-126 distinguishes MCTD patients from all other ACTD groups. The expression level of miRNAs was significantly higher in the serum of systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) patients compared to controls. The miR-145 and -181a levels distinguished RA from other ACDT patients. miR-155 was specific for SLE patients. MiR-132, miR-143, and miR-29a distinguished RA and SLE patients from the systemic sclerosis (SSc) group. Additionally, some clinical parameters were significantly related to the miRNA expression profile in the SLE group. SLE and RA are characterized by a specific serum expression profile of the microRNAs associated with the Toll-like receptors (TLRs) signaling pathway. The analysis showed that their level distinguishes these groups from the control and from other ACTD patients. The present study did not reveal a good biomarker for MCTD patients.</p>
</abstract>
<kwd-group>
<kwd>microRNA</kwd>
<kwd>miRNA serum levels</kwd>
<kwd>MCTD</kwd>
<kwd>ACTD</kwd>
</kwd-group>
</article-meta>
</front>
<floats-group>
<fig id="jcm-09-00161-f001" orientation="portrait" position="float">
<label>Figure 1</label>
<caption>
<p>Serum miR- 29a, miR-145, miR-132, and miR-181a differentiated RA from HC. (
<bold>A</bold>
) Serum expression of seven miRNAs for a candidate RA biomarker. The area under curve (AUC) was calculated after plotting the receiver operating characteristic (ROC) curve. (
<bold>B</bold>
) ROC curve analyses of miR-29a, miR-145, miR-132, and miR-181a, which showed the highest values for AUC. (
<bold>C</bold>
) The sensitivity and specificity test for RA of miRNAs with the highest AUC value. The cutoff value was selected using a method that maximizes sensitivity and specificity simultaneously. IQR, Interquartile range; RA, rheumatoid arthritis; HC, healthy control.</p>
</caption>
<graphic xlink:href="jcm-09-00161-g001"></graphic>
</fig>
<fig id="jcm-09-00161-f002" orientation="portrait" position="float">
<label>Figure 2</label>
<caption>
<p>ROC curve analysis and calculated AUC values of seven miRNAs for the candidate SLE biomarker. (
<bold>A</bold>
) Serum expression of seven miRNAs for candidate SLE biomarker. The AUC was calculated after plotting the ROC curve. (
<bold>B</bold>
) ROC curve analyses of miR- 29a, miR-143, miR-155, and miR-181a, which showed the highest values for AUC. (
<bold>C</bold>
) The sensitivity and specificity test for SLE of miRNAs with the highest AUC value. Cutoff value was selected using a method that maximizes sensitivity and specificity simultaneously. SLE, systemic lupus erythematosus.</p>
</caption>
<graphic xlink:href="jcm-09-00161-g002"></graphic>
</fig>
<fig id="jcm-09-00161-f003" orientation="portrait" position="float">
<label>Figure 3</label>
<caption>
<p>Identification of crucial miRNAs in (
<bold>A</bold>
) a SLE detection model; (
<bold>B</bold>
) a RA detection model; (
<bold>C</bold>
) ROC analysis of the combination of miR-126, miR-145, miR29a, and miR155 in SLE; (
<bold>D</bold>
) ROC analysis of the combination of miR-145 and miR-29a in RA.</p>
</caption>
<graphic xlink:href="jcm-09-00161-g003"></graphic>
</fig>
<fig id="jcm-09-00161-f004" orientation="portrait" position="float">
<label>Figure 4</label>
<caption>
<p>Serum expression of (
<bold>A</bold>
) miR-126, (
<bold>B</bold>
) miR-181a, (
<bold>C</bold>
) miR145, and (
<bold>D</bold>
) miR155 normalized to U6 between ACTD groups, determined by qRT-PCR. Box plots display numerical data through their quartiles. Only significant differences are indicated. *,
<italic>p</italic>
≤ 0.05; **:
<italic>p</italic>
≤ 0.01; ***
<italic>p</italic>
≤ 0.001.</p>
</caption>
<graphic xlink:href="jcm-09-00161-g004"></graphic>
</fig>
<table-wrap id="jcm-09-00161-t001" orientation="portrait" position="float">
<object-id pub-id-type="pii">jcm-09-00161-t001_Table 1</object-id>
<label>Table 1</label>
<caption>
<p>Clinical description of patients who participated in the study.</p>
</caption>
<table frame="hsides" rules="groups">
<thead>
<tr>
<th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Parameters</th>
<th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">MCTD
<italic>n</italic>
= 15</th>
<th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">SLE
<italic>n</italic>
= 24</th>
<th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">RA
<italic>n</italic>
= 18</th>
<th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">SSc
<italic>n</italic>
= 37</th>
</tr>
</thead>
<tbody>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">age</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">48.5 (58.75–33.25)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">36 (46.5–32.75)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">58 (68–49)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">52.5 (57.5–41)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">sex (female)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">12 (85.71%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">19 (95%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">11 (64.7112%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">23 (63.89%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">disease duration (months)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">126 (192–63)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">72 (135–30.75)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">54 (153–12)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">damage index </td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1 (3–0)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1 (1–0)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5.37 (5.76–4.2)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">CRP</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5 (7–3)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4 (6–1.5)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">32 (47.5–23.5)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2 (7–1)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">ESR [mm/h]</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">10 (20–8)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">11.7 (14.15–7.85)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">45 (54–29)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">11 (1–52) </td>
</tr>
<tr>
<td colspan="5" align="center" valign="middle" style="border-bottom:solid thin" rowspan="1">
<bold>Autoantibody profile</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti–CCP</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3 (23.08%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">11 (73.33%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">RF</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3 (25%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">8 (53.33%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4 (13.79%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti-U1-RNP</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">10 (76.92%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2 (12.5%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti-A</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">8 (61.54%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4 (25%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti-C</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5 (38.46%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3 (18.75%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti-70kD</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">9 (69.23%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">ANA titer:</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><1280</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4 (30%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">9 (37.5%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">10 (27%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">≥1280</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">9 (60%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">15 (62.5%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">27 (68%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti–dsDNA</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1 (7.69%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">13 (81.25%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0 (0%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">SSA – Ro52</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2 (15.38%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5 (31.25%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">7 (23.33%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">SSA – Ro60</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0 (0%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5 (31.25%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1 (5.56%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti-SmB</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4 (30.77%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5 (31.25%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0 (0%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti-SmD</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0 (0%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5 (31.25%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0 (0%)</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">anti-Scl70</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1 (7.69%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0 (0%)</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">16 (57.14%)</td>
</tr>
<tr>
<td rowspan="7" align="center" valign="middle" style="border-bottom:solid thin" colspan="1">Therapeutic profile</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Azathioprine – 6%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Ciclosporin – 6%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Anti-IL–6%– 11%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Azathioprine – 13%</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Methotrexate – 23%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Azathioprine – 24%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Glucocorticoids – 61%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Cyclophosphamide – 7%</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Steroids(prednizon) – 77%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Cyclophosphamide – 10%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Anti-TNF – 39%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Other immunosuppressive drugs – 52%</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Chloroquine – 59%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Methotrexate – 10%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Methotrexate – 61%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">methotrexate – 27%</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Steroids (prednizon) – 94%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Corticosteroids – 7%</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Chloroquine –52%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Vasodilators – 84%</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Hydroksychloroquine – 42%</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>MCTD, mixed connective tissue disease; SLE, systemic lupus erythematosus; RA, rheumatoid arthritis; SSc, systemic sclerosis; RF, rheumatoid factor; anti-CCP, anti-cyclic citrullinated peptide autoantibodies, aCCP; anti-Scl-70, anti-topoisomerase I; anti-dsDNA, anti-double stranded DNA, CRP,
<italic>C-reactive protein</italic>
; ESR,
<italic>erythrocyte sedimentation rate</italic>
; SSA, Sjögren’s-syndrome-related antigen. continuous variables were presented as median and Interquartile range (IQR); Categorical variables were presented as percentages.</p>
</fn>
</table-wrap-foot>
</table-wrap>
<table-wrap id="jcm-09-00161-t002" orientation="portrait" position="float">
<object-id pub-id-type="pii">jcm-09-00161-t002_Table 2</object-id>
<label>Table 2</label>
<caption>
<p>Relative expression of circulating microRNA in ACTD patients compared to the healthy control group (expression in the control group is taken as 1).</p>
</caption>
<table frame="hsides" rules="groups">
<tbody>
<tr>
<td colspan="6" align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1">
<bold>SLE</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Upregulated microRNA</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Fold change</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>
<italic>p</italic>
-value</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Downregulated microRNA</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Fold change</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>
<italic>p</italic>
-value</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-29a</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">9.15</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><0.0001</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-155</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">8.57</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.0002</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-143</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">6.15</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.0003</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-181a</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">7.959</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.0009</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-126</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4.15</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.009</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-132</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3.03</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.02</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-145</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4.12</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.03</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="6" align="center" valign="middle" style="border-bottom:solid thin" rowspan="1">
<bold>MCTD</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Upregulated microRNA</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Fold change</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>
<italic>p</italic>
value</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Down regulated microRNA</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Fold change</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>
<italic>p</italic>
value</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-143</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">10.50</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.06</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-126</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4.35</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.09</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-29a</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">8.98</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.1</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-145</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5.73</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.2</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-132</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">7.08</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.3</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-155</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2.8</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.5</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-181a</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1.08</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.7</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="6" align="center" valign="middle" style="border-bottom:solid thin" rowspan="1">
<bold>RA</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Upregulated microRNA</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Fold change</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>
<italic>p</italic>
-value</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Downregulated microRNA</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Fold change</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>
<italic>p</italic>
value</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-181a</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">222.01</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><0.0001</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-145</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">16.67</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"><0.0001</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-29a</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">97.99</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.004</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-132</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">12.04</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.007</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-126</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">334.43</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.01</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-155</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2.86</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.03</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-143</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3.31</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.2</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
<tr>
<td colspan="6" align="center" valign="middle" style="border-bottom:solid thin" rowspan="1">
<bold>SSc</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Upregulated microRNA</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Fold change</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>
<italic>p</italic>
value</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Down regulated microRNA</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>Fold change</bold>
</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">
<bold>
<italic>p</italic>
value</bold>
</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-155</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.06</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-181a</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2.55</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.5</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-126</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2.68</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.2</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-29a</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1.12</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.7</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-145</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2.88</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.3</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-143</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2.45</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.9</td>
</tr>
<tr>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">miR-132</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1.35</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">0.9</td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
<td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<fn>
<p>Wilcoxon test,
<italic>p</italic>
-value < 0.05 was considered to be significant, marked by bold font.</p>
</fn>
</table-wrap-foot>
</table-wrap>
</floats-group>
</pmc>
<affiliations>
<list>
<country>
<li>Pologne</li>
</country>
</list>
<tree>
<country name="Pologne">
<noRegion>
<name sortKey="Stypinska, Barbara" sort="Stypinska, Barbara" uniqKey="Stypinska B" first="Barbara" last="Stypinska">Barbara Stypinska</name>
</noRegion>
<name sortKey="Lewandowska, Aleksandra" sort="Lewandowska, Aleksandra" uniqKey="Lewandowska A" first="Aleksandra" last="Lewandowska">Aleksandra Lewandowska</name>
<name sortKey="Olesinska, Marzena" sort="Olesinska, Marzena" uniqKey="Olesinska M" first="Marzena" last="Olesinska">Marzena Olesinska</name>
<name sortKey="Paradowska Gorycka, Agnieszka" sort="Paradowska Gorycka, Agnieszka" uniqKey="Paradowska Gorycka A" first="Agnieszka" last="Paradowska-Gorycka">Agnieszka Paradowska-Gorycka</name>
<name sortKey="Wajda, Anna" sort="Wajda, Anna" uniqKey="Wajda A" first="Anna" last="Wajda">Anna Wajda</name>
<name sortKey="Walczuk, Ewa" sort="Walczuk, Ewa" uniqKey="Walczuk E" first="Ewa" last="Walczuk">Ewa Walczuk</name>
<name sortKey="Walczyk, Marcela" sort="Walczyk, Marcela" uniqKey="Walczyk M" first="Marcela" last="Walczyk">Marcela Walczyk</name>
</country>
</tree>
</affiliations>
</record>

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