Expression level of miRNA-21 in peripheral blood of children with allergic rhinitis and its clinical significance

  Objective   To investigate expression level of serum miRNA-21 in children with allergic rhinitis(AR).

  Methods   A total of 108 AR children and 45 healthy children were respectively included in AR group and control group. All children with AR were treated with Fluticasone Propionate Nasal Spray combined with Montelukast Sodium Chewable Tablets for 4 weeks. The levels of miRNA-21, eosinophil (EOS) count, eosinophil cationic protein (ECP) and total IgE (TIgE) levels were compared between two groups before and after treatment. The correlations between miRNA-21, EOS count, ECP, TIgE and Visual Analogue Scale (VAS) scores before and after treatment in children with AR were analyzed by Pearson correlation analysis. The clinical efficacy of miRNA-21, EOS count, ECP and TIgE in evaluating the response condition after treatment in children with AR was explored by Receiver Operating Characteristic (ROC) curve.

  Results   A total of 84 children (77.78%) with ARacquired significant efficiency after 4 weeks of treatment. The levels of miRNA-21, ECP, TIgE and EOS count in the AR group were significantly higher than after treatment and control group, and the level of miRNA-21 after treatment in the AR group was significantly higher than those of the control group (P < 0.05). The VAS scores of AR children decreased significantly after treatment (P < 0.05). Before treatment, miRNA-21, EOS count and ECP in the children of the AR group showed significantly positive correlations with VAS scores (r=0.568, 0.433, 0.352). However, there were no correlations between miRNA-21, EOS count, ECP and VAS scores in the AR group after treatment. The Area Under the Curves (AUC) of miRNA-21, ECP, EOS counts, TIgE were 0.913, 0.859, 0.694 and 0.688, respectively. The AUC of miRNA-21 was significantly higher than ECP, EOS counts and TIgE, the AUC of ECP was significantly higher than EOS counts and TIgE, the differences were significant(P < 0.05). However, the comparison of AUCs of EOS counts and TIgE showed no significant difference (P>0.05). The AUC of miRNA-21 combined with ECP in evaluating the significant efficiency after 4 weeks of treatment in children with AR was 0.984 (95%CI, 0.863 to 0.995, P < 0.05), and the specificity and sensitivity was 90.52% and 94.75%, respectively.

  Conclusion   The expression of miRNA-21 in children with AR is significantly higher, which can reflect the severity of the disease. Combined detection of miRNA-21 and ECP or miRNA-21 alone both can predict the clinical efficacy of children with AR.