Diagnostic performance of microRNA-29a in active pulmonary tuberculosis: a systematic review and meta-analysis

Li, Xiaoying; Xu, Yuehong; Liao, Pu

doi:10.1016/j.clinsp.2023.100290

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Review articles • Clinics 78 • 2023 • https://doi.org/10.1016/j.clinsp.2023.100290 copy

Diagnostic performance of microRNA-29a in active pulmonary tuberculosis: a systematic review and meta-analysis

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background:

In recent years, more and more studies have shown that microRNA-29a (miRNA-29a) can be used as a potential biomarker for active tuberculosis, but the results of these studies are not consistent.

Objective:

To comprehensively evaluate the value of miRNA-29a in the diagnosis of active tuberculosis by meta-analysis.

Methods:

The databases of CNKI, WanFang, PubMed, The Cochrane Library, Web of Science and EMBASE were searched for relevant studies. Studies were screened strictly according to inclusion and exclusion criteria. QUA-DAS-2 scale was used to evaluate the quality of the included studies. Data were extracted and analyzed by Meta-DiSc 1.4 and Stata 16.0 software.

Results:

13 articles were included, including a total of 1598 subjects, including 872 active tuberculosis patients and 726 controls. The combined sensitivity and specificity of miRNA-29a in the diagnosis of active tuberculosis were 78 % and 76 %, respectively, and the area under the overall summary receiver operating characteristic curve was 0.8564.

Conclusion:

miRNA-29a can be used as a biomarker for the diagnosis of active tuberculosis.

Keywords:
Tuberculosis; microRNA-29a; Diagnosis; Meta-analysis

HIGHLIGHTS

A meta-analysis was applied to analyze the performance of miRNA-29a in diagnosing active pulmonary tuberculosis.

miRNA-29a can be used as a biomarker for the diagnosis of active tuberculosis.

Tuberculosis burden and sample type of miRNA-29a may influence its diagnostic performance.

Author	Year	Country	Age	TB burden	HIV status (n)	Sample	Dysregulated status	Case/Control (n)	TP	FP	FN	TN
Angria²⁰20 Angria N, Massi MN, Bukhari A, Djaharuddin I, Jumadi O, Ahmad A, et al. Expression of miRNA-29a-3p and IFN-gamma as biomarkers in active and latent pulmonary tuberculosis. Ann Med Surg (Lond) 2022;83:104786.	2022	Indonesia	Adult	High	NA	Blood	Up	50/30	43	8	7	22
Barry¹⁴14 Barry SE, Ellis M, Yang Y, Guan G, Wang X, Britton WJ, et al. Identification of a plasma microRNA profile in untreated pulmonary tuberculosis patients that is modulated by anti-mycobacterial therapy. J Infect 2018;77(4):341–8.	2018	Australia	Adult	Low	NA	Plasma	Up	100/100	37	4	63	96
Cai²¹21 Cai QS, Chen YY, Xia Q, Sun YP. Study on the expression and clinical significance of miRNA in peripheral blood of patients with pulmonary tuberculosis. Chin J Gen Pract 2016;14(4). 546-8,588In Chinese.	2016	China	Adult	High	Negative	Plasma	Up	30/30	24	9	6	21
Cao¹⁸18 Cao SL, Shen AP, Zhu QF, Yang Q, Cao XD, Xing JX, et al. A study on the possibility of using circulating microRNA as biomarkers for the diagnosis of tuberculosis. Chin J Microbiol Immunol 2014(10):787–92. In Chinese.	2014	China	Adult	High	Negative	Plasma	Up	40/60	27	15	13	45
Chen²²22 Chen XF, Xu WF. The expression and clinical significance of miR-29a in peripheral biood of patients with active pulmonary tuberculosis. Chin J Microecol 2017;29(12).1416-1419+1423. In Chinese.	2017	China	Adult	High	NA	Plasma	Up	45/45	30	3	15	42
Fu¹⁵15 Fu Y, Yi Z, Wu X, Li J, Xu F. Circulating microRNAs in patients with active pulmonary tuberculosis. J Clin Microbiol 2011;49(12):4246–51.	2011	China	Adult + child	High	Negative	Serum	Up	30/30	25	6	5	24
Garg¹¹11 Garg J, Garg A, Kumar A. Circulating microRNA 29a: an evolving biomarker for diagnosis of pulmonary tuberculosis. J Clin Diagnostic Res 2021;15(3):DC19–23.	2021	India	Adult	High	NA	Blood	Up	30/30	24	5	6	25
Li¹²12 Li Z, Li C, Bao R, Liu Z. Expressions of miR-29a, TNF-A and vascular endothelial growth factor in peripheral blood of pulmonary tuberculosis patients and their clinical significance. Iran J Public Health 2020;49(9):1683–91.	2020	China	Adult	High	NA	Serum	Up	192/186	172	54	20	132
Liu¹⁹19 Liu YM, Li DD, Zhu SY, Liu QQ, Chen QX, An JN, et al. Expression of miR-29a in peripheral blood leucocyte as biomarker of pulmonary tuberculosis and its diagnostic potential. J Prev Med Inf 2015;31(10):755–8.	2015	China	Adult	High	Negative	Blood	Up	60/20	42	6	18	14
Ndzi¹⁶16 Ndzi EN, Nkenfou CN, Mekue LM, Zentilin L, Tamgue O, Pefura EWY, et al. MicroRNA hsa-miR-29a-3p is a plasma biomarker for the differential diagnosis and monitoring of tuberculosis. Tuberculosis (Edinb) 2019;114:69–76.	2019	Cameroon	Adult + child	Low	Positive (17)	Plasma	Up	62/42	50	12	12	30
Wagh¹⁷17 Wagh V, Urhekar A, Modi D. Levels of microRNA miR-16 and miR-155 are altered in serum of patients with tuberculosis and associate with responses to therapy. Tuberculosis (Edinb) 2017;102:24–30.	2017	India	Adult	High	Negative	Serum	Down	30/30	29	16	1	14
Zhan²³23 Zhan Y, Liu SY, Liu YW, Liu HZ, Zhou ST, Li X, et al. Diagnose value of miR-29a and T-SPOT assay in active pulmonary tuberculosis patients. J Clin Hematol 2019;32(10):765–8. In Chinese.	2019	China	Adult	High	Negative	Plasma	Up	151/78	142	28	9	50
Zhang²⁴24 Zhang GD, Lei D, Zhu YB, Wu HL. Expression and significance of the plasma miR-29 family and interferon-gamma in serum and peripheral blood mono-nuclear cells of patients with active pulmonary tuberculosis. Chin J Diffic Compl Cas 2021;20(11):1131–5. In Chinese.	2021	China	Adult	High	Negative	Plasma	Up	52/45	35	9	17	36

Subgroups	Studies (n)	Sensitivity	Specificity
Age
Adult	11	0.78 (0.74‒0.80)	0.76 (0.73‒0.79)
Adult + child	2	0.82 (0.72‒0.89)	0.75 (0.63‒0.84)
TB burden
High	11	0.84 (0.81‒0.86)	0.73 (0.69‒0.76)
Low	2	0.54 (0.46‒0.62)	0.89 (0.82‒0.93)
Sample type
Plasma	7	0.72 (0.68‒0.76)	0.80 (0.76‒0.84)
Serum	3	0.90 (0.85‒0.93)	0.69 (0.63‒0.75)
Blood	3	0.78 (0.70‒0.84)	0.76 (0.65‒0.85)
Dysregulation status
Up	12	0.77 (0.74‒0.80)	0.77 (0.74‒0.80)
Down	1	-	-

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E-mail: clinics@hc.fm.usp.br

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[1] * Corresponding author E-mail address: ivyyy22@163.com (X. Li).