南京医科大学附属常州第二人民医院呼吸与危重症医学科江苏 常州 213003
目的：评估外周血circ_0070934/miR-199a-5p/MGAT3在过敏性鼻炎-哮喘综合症（combined allergic rhinitis and asthma syndrome, CARAS）中的诊断价值。方法：收集CARAS患者38例和健康对照43例，采集外周静脉血，采用ELISA法检测血浆中MGAT3蛋白水平，采用实时荧光定量 PCR 法检测外周血中circ_0070934/miR-199a-5p/MGAT3的表达水平。ROC曲线判断指标的诊断敏感性与特异性。结果：ELISA结果显示，CARAS患者中MGAT3的浓度较对照组明显下降（P=0.035）。qRT-PCR结果显示，circ_0070934（P=0.001）与MGAT3（P<0.001）的表达较对照组下调，而miR-199a-5p的表达水平上调（P=0.013）。相关性分析结果显示，MGAT3与嗜酸性粒细胞直接计数、嗜酸性粒细胞百分比呈正相关；circ_0070934与二者呈负相关。ROC曲线分析，MGAT3为最佳参数，取界值为0.208时，其敏感性和特异性分别为73.7%和100%，AUC为0.933（95%CI=0.882-0.984，P<0.001）；circ_0070934、miR-199a-5p和MGAT3三个指标联合时，对CARAS的诊断价值最高，取界值为0.539时，敏感性为92.1%，特异性为93%，AUC为0.959（95%CI=0.916-1.000，P<0.001）。结论：CARAS患者外周血circ_0070934/miR-199a-5p/MGAT3的表达存在差异，可作为诊断CARAS的生物标志物。进一步研究circ_0070934/miR-199a-5p/MGAT3在CARAS中的具体作用和机制，有助于发现CARAS新的诊治靶点。
Objective: To evaluate the diagnostic value of peripheral blood circ_0070934/miR-199a-5p/MGAT3 in combined allergic rhinitis and asthma syndrome (CARAS).Methods: Peripheral venous blood was collected from 38 CARAS patients and 43 healthy controls. Plasma MGAT3 protein level was detected by ELISA, and the expression level of circ_0070934/miR-199a-5p/MGAT3 in peripheral blood was detected by quantitative real-time PCR (qRT-PCR). Diagnostic sensitivity and specificity were determined by ROC curve. Results: ELISA results showed that MGAT3 concentration in CARAS patients was significantly lower than that in control group (P=0.035). The circ_0070934 (P=0.001) and MGAT3 mRNA expressions (P<0.001) in CARAS patients were down-regulated when compared with control group, while miR-199a-5p was up-regulated (P=0.013). Correlation analysis showed that MGAT3 was positively correlated with the count of eosinophils and the percentage of eosinophils, while circ_0070934 showed a negative correlation. ROC curve analysis indicated that MGAT3 was the best parameter. When the cut-off value was 0.208, the sensitivity and specificity were 73.7% and 100%, respectively, and the AUC was 0.933 (95%CI=0.882-0.984, P<0.001). The combination of circ_0070934, miR-199a-5p and MGAT3 had the highest diagnostic value for CARAS. When the cut-off value was 0.539, the sensitivity was 92.1%, the specificity was 93%, and the AUC was 0.959 (95%CI=0.916-1.000, P<0.001).Conclusion: Altered expressions of circ_0070934/miR-199a-5p/MGAT3 were confirmed in the peripheral blood of CARAS patients, which can be used as a biomarker for the diagnosis of CARAS. Further researches on the specific role and mechanism of circ_0070934/miR-199a-5p/MGAT3 in CARAS will help to discover new diagnostic and therapeutic targets of CARAS.