血浆外泌体微RNA-126-5p在儿童注意缺陷多动障碍中的表达及临床意义  

Expression and clinical significance of plasma exosome miR-126-5p in children with attention deficit hyperactivity disorder

作　　者：章素芬 田甜[1] 胡幼芳[1] ZHANG Sufen;TIAN Tian;HU Youfang(Department of Child Healthcare,Jiangsu Province Hospital,The First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210000,China)

机构地区：[1]江苏省人民医院、南京医科大学附属第一医院保健科,江苏南京210000

出　　处：《安徽医药》2024年第8期1547-1551,I0001,共6页Anhui Medical and Pharmaceutical Journal

基　　金：国家自然科学基金(82101618);国家卫生健康委医药卫生科技发展项目(WA2020HK11);江苏省卫生健康委项目(FXK201705);江苏省妇幼健康科研面上重点项目(F201804);南京医科大学第一附属医院青年基金培育计划项目(P2022055)。

摘　　要：目的探究血浆外泌体微RNA-126-5p(miR-126-5p)在儿童注意缺陷多动障碍(ADHD)中的表达及临床意义。方法选取2021年7月至2022年7月在江苏省人民医院确诊的ADHD病儿70例为ADHD组,同时纳入同期江苏省人民医院健康体检的志愿者70例为对照组,采用韦氏幼儿智力量表第4版(WISC-Ⅳ)和家长评定行为量表(SNAP-Ⅳ)评估研究对象的临床症状,采用miRNA测序绘制研究对象的差异miRNA表达谱后寻找关键的miRNA,并利用受试者操作特征曲线(ROC曲线)评价miRNA诊断ADHD的价值,分析miRNA与临床症状的相关性,同时分析miRNA的生物学功能。结果与对照组比较,ADHD病儿WISC-Ⅳ的计算言语理解指数(VCI)[(76.99±6.93)分比(95.30±5.94)分]、知觉推理指数(PRI)[(75.38±4.49)分比(94.69±6.33)分]、工作记忆指数(WMI)[(76.35±7.01)分比(94.11±5.87)分]、加工速度指数(PSI)[(81.36±6.90)分比(89.49±6.20)分]以及总智商(FSIQ)[(79.18±9.30)分比(90.19±5.22)分]的分值显著降低,而SNAP-Ⅳ中注意缺陷和多动/冲动评分明显增高。同时miRNA测序筛选出11个差异miRNAs,其中miR-126-5p在ADHD病儿的血浆外泌体表达升高,并与病儿临床症状存在相关性,且ROC曲线显示miR-126-5p的AUC为0.817,灵敏度为78.6%,特异度为91.4%。此外miR-126-5p主要涉及突触囊泡循环、轴突导向、炎症介质以及长时程增强等生物学功能有关。结论ADHD病儿血浆外泌体miR-126-5p升高,具有诊断ADHD的临床应用价值,同时具有调控突触可塑性和炎症介质参与ADHD的病理机制。Objective To investigate the expression and clinical significance of plasma exosome miR-126-5p in children with attention deficit hyperactivity disorder(ADHD).Methods A total of 70 ADHD patients in Jiangsu Province Hospital from July 2021 to July 2022 were selected as ADHD group,at the same time,70 healthy volunteers from Jiangsu Province Hospital during the same period were included as the control group.The clinical symptoms of the subjects were evaluated by the Wechsler Infant Intelligence ScaleⅣ(WSC-Ⅳ)and the Parent Rating Behavior Scale(SNAP-Ⅳ).miRNA sequencing was used to draw the differential miRNA expression profiles of the subjects,and then the key miRNA were found.The value of miRNA in the diagnosis of ADHD was evaluated using the subjects operating characteristics(ROC)curve,and the correlation between miRNA and clinical symptoms was analyzed.Meanwhile,the biological function of miRNA was analyzed.Results The scores of verbal comprehension index(VCI)[(76.99±6.93)score vs.(95.30±5.94)score],perception reasoning index(PRI)[(75.38±4.49)score vs.(94.69±6.33)score],working memory index(WMI)[(76.35±7.01)score vs.(94.11±5.87)score],processing speed index(PSI)[(81.36±6.90)score vs.(89.49±6.20)score]and total intelligence quotient(FSIQ)[(79.18±9.30)score vs.(90.19±5.22)score]in the WISC-Ⅳof ADHD patients were significantly decreased,while the scores of attention deficit and hyperactivity/impulsivity in the SNAP-Ⅳwere significantly increased.At the same time,11 different miRNAs were screened by miRNA sequencing,among them,miR-126-5p expression was increased in plasma exosomes of ADHD patients and was correlated with clinical symptoms of patients.ROC curve showed that the area under the curve(AUC)of miR-126-5p was 0.817,the sensitivity was 78.6%,and the specificity was 91.4%.In addition,miR-126-5p was mainly involved in biological functions such as synaptic vesicle circulation,axonal guidance,inflammatory mediators and long-term potentiation.Conclusion The plasma exosome miR-126-5p in ADHD patie

关 键 词：注意力缺陷障碍伴多动 微RNA-126-5p 外泌体 诊断 

分 类 号：R749.94[医药卫生—神经病学与精神病学]