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Schuchardt EL, Miyamoto SD, Crombleholme T, Karimpour-Fard A, Korst A, Neltner B, Howley LW, Cuneo B, Sucharov CC. Amniotic Fluid microRNA in Severe Twin-Twin Transfusion Syndrome Cardiomyopathy-Identification of Differences and Predicting Demise. J Cardiovasc Dev Dis 2022; 9:37. [PMID: 35200691 PMCID: PMC8878714 DOI: 10.3390/jcdd9020037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/10/2022] [Accepted: 01/18/2022] [Indexed: 12/15/2022] Open
Abstract
Twin-twin transfusion syndrome (TTTS) is a rare but serious cause of fetal cardiomyopathy with poorly understood pathophysiology and challenging prognostication. This study sought a nonbiased, comprehensive assessment of amniotic fluid (AF) microRNAs from TTTS pregnancies and associations of these miRNAs with clinical characteristics. For the discovery cohort, AF from ten fetuses with severe TTTS cardiomyopathy were selected and compared to ten normal singleton AF. Array panels assessing 384 microRNAs were performed on the discovery cohort and controls. Using a stringent q < 0.0025, arrays identified 32 miRNAs with differential expression. Top three microRNAs were miR-99b, miR-370 and miR-375. Forty distinct TTTS subjects were selected for a validation cohort. RT-PCR targeted six differentially-expressed microRNAs in the discovery and validation cohorts. Expression differences by array were confirmed by RT-PCR with high fidelity. The ability of these miRNAs to predict clinical differences, such as cardiac findings and later demise, was evaluated on TTTS subjects. Down-regulation of miRNA-127-3p, miRNA-375-3p and miRNA-886 were associated with demise. Our results indicate AF microRNAs have potential as a diagnostic and prognostic biomarker in TTTS. The top microRNAs have previously demonstrated roles in angiogenesis, cardiomyocyte stress response and hypertrophy. Further studies of the mechanism of actions and potential targets is warranted.
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Affiliation(s)
- Eleanor L. Schuchardt
- Department of Pediatrics, Colorado Fetal Care Center, Children’s Hospital Colorado, School of Medicine, University of Colorado, Aurora, CO 80045, USA; (E.L.S.); (S.D.M.); (B.C.)
- Department of Pediatrics, Rady Children’s Hospital, School of Medicine, University of California San Diego, San Diego, CA 92123, USA
| | - Shelley D. Miyamoto
- Department of Pediatrics, Colorado Fetal Care Center, Children’s Hospital Colorado, School of Medicine, University of Colorado, Aurora, CO 80045, USA; (E.L.S.); (S.D.M.); (B.C.)
| | - Timothy Crombleholme
- Fetal Care Center Dallas, Medical City Children’s Hospital, Dallas, TX 75230, USA;
| | - Anis Karimpour-Fard
- Department of Pharmacology, School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, CO 80045, USA;
| | - Armin Korst
- Research Institute, Children’s Hospital Colorado, Aurora, CO 80045, USA;
| | - Bonnie Neltner
- Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA;
| | - Lisa W. Howley
- Division of Cardiology, Department of Pediatrics, The Children’s Heart Clinic, Children’s Minnesota, Minneapolis, MN 55404, USA;
| | - Bettina Cuneo
- Department of Pediatrics, Colorado Fetal Care Center, Children’s Hospital Colorado, School of Medicine, University of Colorado, Aurora, CO 80045, USA; (E.L.S.); (S.D.M.); (B.C.)
| | - Carmen C. Sucharov
- Division of Cardiology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO 80045, USA;
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