Diagnostic and therapeutic significance of exosomal miR-143-5p in the plasma of patients with rheumatoid arthritis

OBJECTIVE: This study aimed to evaluate the expression levels of exosomal microRNA (miRNA) in patients with rheumatoid arthritis (RA) and to assess the diagnostic and therapeutic significance of these biomarkers in the context of RA. METHODS: Plasma-derived exosomes were isolated from patients with RA and from healthy control participants, followed by miRNA sequencing. Key differentially expressed miRNAs were initially identified and validated in a pilot cohort and subsequently confirmed in an expanded sample population. An independent t-test was applied to compare miRNA expression profiles between patients with RA and healthy controls, as well as between pre- and post-treatment states in the RA group. The diagnostic utility of selected miRNAs was assessed using receiver operating characteristic (ROC) analysis. Additionally, associations between miRNA expression levels and clinical parameters, including erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti-cyclic citrullinated peptide antibody (anti-CCP), and C-reactive protein (CRP), was evaluated using Pearson's correlation coefficient. RESULTS: Plasma exosomal miR-143-5p expression was significantly elevated in patients with RA prior to treatment. Following therapeutic intervention, expression levels of miR-143-5p were not significantly different from those observed in healthy controls. ROC curve analysis demonstrated a high diagnostic value for plasma exosome miR-143-5p, with an area under the curve of 0.918, sensitivity of 93.3% and specificity of 85.7%. Additionally, miR-143-5p levels were positively correlated with clinical inflammatory markers, including ESR, RF, anti-CCP, and CRP. CONCLUSION: Plasma exosomal miR-143-5p demonstrates strong diagnostic potential in individuals with RA and may contribute to the understanding of disease pathogenesis. Modulation of miR-143-5p expression could serve as a valuable biomarker for disease assessment and represents a potential therapeutic in the management of RA.