Long Noncoding RNA Biomarkers in Pediatric Patients With ITP

IFNG antisense RNA 1 (IFNG-AS1) and growth arrest-specific 5 (GAS5) are long noncoding RNAs (lncRNAs) associated with the interferon-gamma (IFN-γ) transcript and glucocorticoid resistance, respectively. Both are directly linked to several autoimmune disorders. Researchers examined these lncRNAs in pediatric patients with immune thrombocytopenia (ITP) and concluded that IFNG-AS1 and GAS5 could serve as novel diagnostic and prognostic biomarkers.

The study, published in Frontiers in Molecular Biosciences, examined blood samples from children with ITP and healthy controls. Fold changes of lncRNAs of interest were evaluated using quantitative, real-time polymerase chain reaction for any associations with ITP pathophysiology, clinical presentations, and treatment response.

IFNG-AS1 and GAS5 Levels Distinguish ITP Subjects

Overall, children with ITP had overexpressed IFNG-AS1 (median, 3.08; interquartile range [IQR], 0.2-22.39) and GAS5 (median, 4.19; IQR, 0.9-16.91) serum levels.

Further, patients who had persistent ITP (IFNG-AS1 median, 4.58; IQR, 0.31-22.39; GAS5 median, 3.77; IQR, 0.87-12.36) and chronic ITP (IFNG-AS1 median, 5.6; IQR, 0.25-12.59; GAS5 median, 5.61; IQR, 1.15-16.91) had significantly higher IFNG-AS1 and GAS5 compared with patients who were within 3 months of their diagnosis (IFNG-AS1 median, 1.21; IQR, 0.2-8.95; GAS5 median, 1.07; IQR, 0.09-3.55; P<.05).

Compared with patients who achieved complete response to treatment (IFNG-AS1 median, 2.09; IQR, 0.2-14.58; GAS5 median, 2.51; IQR, 0.09-10.33), patients who had partial response (IFNG-AS1 median, 4.15; IQR, 0.94-19.25; GAS5 median, 4.25; IQR, 0.81-16.91) or no response (IFNG-AS1 median, 4.19; IQR, 1.25-22.39; GAS5 median, 5.11; IQR, 2.34-15.27) had significantly higher IFNG-AS1 and GAS5.

The researchers noted the expression levels of IFNG-AS1 and GAS5 were significantly negatively correlated with patients’ platelet counts.

Ultimately, the authors suggested that “lncRNAs IFNG-AS1 and GAS5 are novel diagnostic and prognostic genetic markers for childhood ITP that can aid in a precise prediction of the disease’s progress at the time of diagnosis and could be a useful tool for treatment planning.”

Related: First-Line and Subsequent ITP Therapies Under Australia’s Treatment Restrictions