Highlights
- •miRNA differentiate SAH complications such as delayed cerebral infarction.
- •Early Brain Injury restructures miRNA expression in cerebrospinal fluid.
- •miRNA fingerprints reflect blood-brain barrier instability, autophagy and apoptosis.
- •miRNA in SAH and ischemic stroke overlap and highlight shared pathophysiology.
Abstract
Background
Subarachnoid hemorrhage (SAH) is fatal and detrimental to quality of life.
Clinically, options for monitoring are often limited, potentially missing subtle neurological
changes especially in low-grade patients. This article reviewed miRNA dysregulation
in SAH and analyzed their functional and clinical relevance.
Methods
With adherence to PRISMA guideline, PubMed, EMBASE, GEO and ArrayExpress were searched
comprehensively for relevant clinical and animal models. Datasets were analyzed and
enriched by experimentally validated targets and multiple databases using R v3.4.2,
Ingenuity Pathway Analysis, and miRPath v3.0.
Results
Among 1926 search results, 18 studies were screened for full-text assessment. The
8 included studies revealed a marked miRNA dysregulation after SAH. 2 datasets were
retrieved. In both serum and CSF, different miRNA profiles were associated with Early
Brain Injury, Delayed Cerebral Infarction, vasospasm and prognosis. In CSF, a dramatic
restructure of inter-miRNA correlation matrix was observed. Enrichment analysis revealed
strong association (1) BBB instability, with adherens, extra-cellular matrix, actin
cytoskeleton, integrin, TGF-β, Wnt/β-catenin etc; (2) autophagy, with MTORC1, HIF-1,
ULK2, and FoxO etc; (3) apoptosis, with PI3K-Akt, p53, and AMPK. We analyzed common
miRNAs across SAH and cerebral ischemia. They were related to neuronal differentiation,
oxidation stress, apoptosis, angiogenesis, Alzheimer’s disease, NMDA-induced calcium
influx, excitotoxicity and NO production.
Conclusions
Clinical progression of SAH is associated with different miRNA fingerprints. They
carry neuro-pathological relevance and can be a potential biomarker which compliments
SAH management.
Keywords
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Article info
Publication history
Published online: November 24, 2018
Accepted:
November 10,
2018
Received:
September 22,
2018
Identification
Copyright
© 2018 Elsevier Ltd. All rights reserved.
