Plasma miRNAs as potential biomarkers for schizophrenia in a Jordanian cohort

Background

Schizophrenia (SZ), a complex and chronic neuropsychiatric disorder affecting approximately 1 % of the general population, presents diagnostic challenges due to the absence of reliable biomarkers, and relying mainly on clinical observations. MicroRNAs (miRNAs) signatures in a wide range of diseases, including psychiatric disorders, hold immense potential for serving as biomarkers. This study aimed to analyze the expression levels of specific microRNAs (miRNAs) namely miR-29b-3p, miR-106b-5p, and miR-199a-3p and explore their diagnostic potential for SZ in Jordanian patients.

Methods

Small RNAs (miRNAs) were extracted from plasma samples of 30 SZ patients and 35 healthy controls. RNA was reverse transcribed and quantified by real-time polymerase chain reaction (qRT-PCR). The expression levels of three miRNAs (miR-29b-3p, miR-106b-5p and miR-199a-3p) were analyzed. Receiver operating characteristic (ROC) curves analysis was performed to evaluate diagnostic value of these miRNAs. Target genes prediction, functional enrichment and pathway analyses were done using miRWalk and Metascape. STRING database was used to construct protein-protein network and identify hub genes.

Results

Notably, miR-106b-5p and miR-199a-3p were significantly upregulated (p < 0.0001), while miRNA-29b-3p was downregulated (p < 0.0001) in SZ patients compared to controls. The diagnostic potential was assessed through ROC curves, revealing substantial diagnostic value for miR-199a-3p (AUC: 0.979) followed by miR-106b-5p (AUC: 0.774), with limited diagnostic efficacy for miR-29b-3p. Additionally, bioinformatic analyses for the predicted target genes of the diagnostically significant miRNAs uncovered Gene Ontology (GO) terms related to neurological development, including morphogenesis, which is involved in neuron differentiation, brain development, head development, and neuron projection morphogenesis. These findings highlight a potential connection between the identified miRNAs and SZ pathophysiology in the studied Jordanian population. Furthermore, a protein-protein interaction network from the target genes identified in association with neurological development in the Gene Ontology (GO) terms deepens our comprehension of the molecular landscape of the regulated target genes.

Conclusions

This comprehensive exploration highlights the promising role of miRNAs in unraveling intricate molecular pathways associated with SZ in the Jordanian cohort and suggests that plasma miRNAs could serve as reliable biomarkers for SZ diagnosis and disease progression. Remarkably, this study represents the first investigation into the role of circulating miRNA expression among Jordanian patients with SZ, providing valuable insights into the diagnostic landscape of this disorder.

P1796 Three dimensional echocardiograhy navigation of mitral valve in patients with left ventricular dysfunction and functional mitral regurgiation

OnBehalf

cairo university

Background

Mitral valve MV apparatus is a dynamic three-dimensional system that allows a unidirectional heart pump function. Functional mitral regurgitation (FMR) is a common complication that adversely affects the prognosis in patients with congestive heart failure. Accurate assessment of the interaction of the LV and MV apparatus is crucial for surgical correction of FMR.

Purpose

Evaluation of MV deformity indices in patients with Left ventricle (LV) dysfunction and varying severity FMR using 3D transoesophageal echocardiography and MV navigation (MVN) software

Methods

96 patients were selected with echocardiographic evidence of dilated LV dimensions, EF ≤ 45%,and at least mild MR . A standard comprehensive transthoracic echocardiographic assessment of : 1. LV diameters and volumes with calculation of LVEF , LV shape, sphericity index, 2. Mitral leaflets morphology including anterior mitral leaflet length ,Mitral annular (MA) diameter , mid-systolic mitral annular area (MAA) , The coaptation height (CH) or distance , MV tenting area, leaflet-tethering distance for anterolateral papillary muscle (Tethering-AL) and posteromedial papillary muscle (Tethering-PM), 3.Quantification of MR : MR jet area , vena contracta (VC) width, effective regurgitant orifice area (EROA), , regurgitant volume, 4. 2D speckle-tracking imaging for LV strain analysis,5.MV morphology and dynamics were analysed using MVN for assessment of : Annular geometry including diameters, circumference ,height , annular ellipticity .

Results

MV deformation (AML and PML tethering distance) was negatively correlated with GLS (r= -0.408, p = 0.009),and (r= -0.428, p = 0.006) as well as 2D and 3D MAA were negatively correlated with the GLS (r= -0.469, p = 0.002) and (r= -0.477, p = 0.002). MR severity parameters as MR volume and EROA were associated with increased MAA (r = 0.38, p = 0.015), (r = 0.469, p = 0.002) respectively. Severity of MR was strongly correlated with MVA indices including AP diameter, 3D MA circumference, MAA, MV tenting height and volume and annular ellipsicity.

Conclusion

Mitral annular enlargement appears to be more closely linked to occurrence of FMR in patients with LV dysfunction. 3D imaging modalities will help assessment of complicated, dynamic, three-dimensional and non-planar mitral annulus

P779 Use of right ventricular strain analysis to detect right ventricle subtle dysfunction in patients with left ventricular ischemic cardiomyopathy

Purpose

Evaluation of different RV functions and prevalence of RV dysfunction in patients with ischemic cardiomyopathy (ICM) (EF &lt; 50%), using echocardiographic conventional methods and RV strain analysis

Methods

All our patients had ischemic cardiomyopathy (ICM) (EF&lt; 50), patients with previous inferior myocardial infarction were excluded. A standard comprehensive transthoracic echocardiographic assessment of the RV dimensions, conventional systolic parameters: TAPSE, fractional area change FAC, S" velocity, myocardial performance index (RV MPI- RV Tie index ) and diastolic parameters (E/A, E/E", DT). 2 Dimensional speckle tacking echocardiography (2D-STE) for right ventricular global strain analysis (RVGLS): RVGLS total and RVGLS free wall (RVGLS total is a measurement obtained from the average value of all six segments values and RVGLS free wall is the average value from three RV free wall segments) , RV and LV peak systolic strain rate (RV SRs, LV SRs) and early diastolic strain rate (RV SRe, LV SRe) were measured.

Results : we enrolled 50 patients (out of 1026 patients over one year ) 37 males (74%) , mean age 60.8 ± 7.4 years, according to RV strain analysis patients were divided into two groups, group I : patients who had normal RV function (RV free wall peak systolic strain PSS ≤-20%), and group II : had impaired RV function (RV free wall PSS &gt;-20%) .

there was no statistically significant difference between the two groups as regards LV dimensions, LV EF, LV GLS , LV SRs, RV dimensions nor other RV conventional parameters as TAPSE, FAC, S", or RV MPI. However mean RV GLS in group (I) was -17.52 ± 8.60 % vs -11.66 ± 3.25 % in group (II), (p = 0.003). Mean RV SRs in group (I) was -1.02 ± 0.27 /s vs -0.74 ± 0.38 /s in group (II), (p = 0.001)

There was a statistically significant correlation between RV MPI and RV GLS (r = 0.315, p = 0.026), RVSRs and RV GLS (r = 0.656, p &lt; 0.001) and between RV SRs and RVGLS free wall (r = 0.631, p &lt; 0.001). There was a statistically significant correlation between RV SRs and RVGLS free wall in group (I) (r = 0.693, p &lt; 0.001) and in group (II) (r = 0.819, p &lt; 0.001).

There was no agreement between TAPSE and RV GLS free wall (Kappa 0.063, p 0.2). MPI was the only conventional parameter that correlated with RV GLS free wall (p0.026).

Conclusion

RVGLS is a global, more sensitive parameter of RV systolic function compared to commonly used conventional parameters,it correlates better with RV systolic function and may have a more prognostic power for detection of subtle RV dysfunction.

Endoscope affects decision making in cholesteatoma surgery

OBJECTIVE

The aim of the present study was to evaluate the use of intraoperative otoendoscopy as a factor that could influence surgical decision-making in cholesteatoma surgery.

MATERIALS AND METHODS

The material of this study included 82 ears with acquired cholesteatoma that were operated on. They were divided into 4 groups according to the surgical technique chosen and the use of the endoscope. Group I included 22 ears that underwent canal wall-down (CWD) tympanomastoid surgery, group II included 20 ears that underwent CWD tympanomastoid surgery with intraoperative use of endoscopy, group III included 20 ears that underwent canal wall-up (CWU) tympanomastoid surgery, and group IV included 20 ears that underwent CWU tympanomastoid surgery with intraoperative use of endoscopy. Endoscopy was used as a complementary tool to microscopy. The follow-up period ranged from 12 to 48 months.

RESULTS

Intraoperative remnants of cholesteatoma matrix were detected during both CWU and CWD by the use of the rigid endoscope. However, its incidence was higher in the CWU group (50%) than in the CWD (30%) group. Most of these remnants were in the sinus tympani (37.5%). The mean duration of follow-up was 18.19 (+/-8.7) months. Postoperative residual cholesteatoma was much higher in the CWU group (25%) than in the CWD group (5%). All residuals were from groups of patients in whom intraoperative endoscopy was not used in the primary surgery.

CONCLUSION

Our results showed that the use of the endoscope gave the surgeon better control over the pathology, thus achieving better eradication. Stated differently, the use of the endoscope raised the surgeon's confidence level about total removal and thus encouraged the surgeon to keep the canal wall intact while removing cholesteatoma in hidden areas. Therefore, the use of endoscope could be considered an additional tool that may affect decision-making in cholesteatoma surgery.

Endoscope Affects Decision Making in Cholesteatoma Surgery

OBJECTIVE: The aim of the present study was to evaluate the use of intraoperative otoendoscopy as a factor that could influence surgical decisionmaking in cholesteatoma surgery.

MATERIALS AND METHODS: The material of this study included 82 ears with acquired cholesteatoma that were operated on. They were divided into 4 groups according to the surgical technique chosen and the use of the endoscope. Group I included 22 ears that underwent canal wall-down (CWD) tympanomastoid surgery, group II included 20 ears that underwent CWD tympanomastoid surgery with intraoperative use of endoscopy, group III included 20 ears that underwent canal wall-up (CWU) tympanomastoid surgery, and group IV included 20 ears that underwent CWU tympanomastoid surgery with intraoperative use of endoscopy. Endoscopy was used as a complementary tool to microscopy. The follow-up period ranged from 12 to 48 months.

RESULTS: Intraoperative remnants of cholesteatoma matrix were detected during both CWU and CWD by the use of the rigid endoscope. However, its incidence was higher in the CWU group (50%) than in the CWD (30%) group. Most of these remnants were in the sinus tympani (37.5%). The mean duration of follow-up was 18.19 (±8.7) months. Postoperative residual cholesteatoma was much higher in the CWU group (25%) than in the CWD group (5%). All residuals were from groups of patients in whom intraoperative endoscopy was not used in the primary surgery.

CONCLUSION: Our results showed that the use of the endoscope gave the surgeon better control over the pathology, thus achieving better eradication. Stated differently, the use of the endoscope raised the surgeon's confidence level about total removal and thus encouraged the surgeon to keep the canal wall intact while removing cholesteatoma in hidden areas. Therefore, the use of endoscope could be considered an additional tool that may affect decision-making in cholesteatoma surgery.