Host and MTB Genome Encoded Mirna Markers for Diagnosis Of
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Tuberculosis 116 (2019) 37–43 Contents lists available at ScienceDirect Tuberculosis journal homepage: www.elsevier.com/locate/tube Diagnostics Host and MTB genome encoded miRNA markers for diagnosis of tuberculosis T Sanjiban Chakrabartya, Ajay Kumarb, Kuthethur Raviprasada, Sandeep Mallyac, ∗∗ ∗ Kapaettu Satyamoorthya, , Kiran Chawlab, a Department of Cell and Molecular Biology, School of Life Sciences, Manipal Academy of Higher Education, Manipal, India b Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India c Department of Bioinformatics, School of Life Sciences, Manipal Academy of Higher Education, Manipal, India ABSTRACT MicroRNAs (miRNAs) are a class of noncoding RNA molecules which are involved in various cellular and physiological processes. Previously, studies have identified several miRNAs that are potential diagnostic biomarkers for various infectious diseases including tuberculosis. We have performed small RNA sequencing using the Ion Torrent PGM platform in extra pulmonary tuberculosis (EPTB) subject's serum samples to identify circulating miRNAs during mycobacterium tuberculosis (MTB) infection. Our analysis identified 20 circulating miRNAs upregulated and 5 miRNAs downregulated during MTB infection in patient's serum. In addition, we have identified 6 MTB genome encoded miRNAs upregulated in EPTB patient's serum samples. Taqman based qRT-PCR analysis of host-genome encoded (hsa-miR-146a-5p and hsa-miR-125b-5p) and MTB genome encoded (MTB-miR5) miRNAs showed increased expression in a cohort of 52 healthy, pulmonary tuberculosis (PTB) and extra pulmonary tuberculosis (EPTB) patients serum samples. Our study identified for the first time a panel of host and MTB genome specificdifferentially expressed circulating miRNAs in serum samples of an Indian patient cohort with tuberculosis infection with a potential as a non-invasive diagnostic biomarker for tuberculosis infection. 1. Introduction to the limitations in conventional methods for diagnosis of TB, re- searchers in the past have emphasized the need for development of Despite advancement in pulmonary medicine in past few decades, diagnostic tests based on host biomarkers that can be used for assess- tuberculosis (TB) globally continues to be the major cause of mortality ment of disease status and monitoring of treatment outcomes [5,6]. and morbidity due to an infectious agent. According to World Health Major challenge for developing an ideal biomarker is to ensure that the Organization (WHO) report 10.4 million people fell ill with TB in 2016; discovered biomarker is a stable molecule, abundantly present in body 6.3 million among them were new cases and 0.49 million had multidrug fluids, can be easily recovered, offers high sensitivity and specificity resistant TB. In 2016, TB accounted for 1.3 million deaths alone and with translational potential as a point of care test. In the above context, 0.37 million deaths among HIV co-infected people [1]. Although, early human MicroRNAs (miRNA), a class of non-coding highly conserved diagnosis and appropriate treatment can prevent most TB related single stranded small RNAs of approximately 18–25 nucleotides in deaths, limited availability of a reliable tool for diagnosis of TB remains length that modulate the expression of genes involved in development, one of the major obstacles in controlling the spread of this epidemic. cell differentiation, proliferation, and apoptosis are promising candi- Current standards of TB diagnosis are based on detection of pathogens dates for use as a biomarker [7–10]. Recently, researchers have high- in the sample thus rely heavily on bacterial load which makes the di- lighted the importance of miRNAs in diagnosis of infectious diseases agnosis even challenging especially in smear negative pulmonary TB [11–13]. A preliminary study on circulating miRNAs in patients with cases, extrapulmonary TB and paediatric TB cases where bacterial load active pulmonary TB reported 59 upregulated and 33 downregulated is often low [2–4]. Various methods are employed for the diagnosis of signatures when compared to non-TB controls [14]. Another study EPTB such as radiology, smear microscopy, culture identification, his- identified miR-3179 and miR-147 overexpression during TB infections topathology, tuberculin skin test (TST), serological assays, all these in patients sputum as compared to controls [15]. It has been reported methods have limitations such as suboptimal sensitivity or specificity that miRNA-144 is highly expressed in peripheral blood mono nuclear and time delays whereas, tests based on DNA amplification or inter- cell while miRNA-361-5P, miRNA-889, and miRNA-576-3p were sig- feron-γ release are expensive. MTB is known to modulate host cellular nificantly upregulated in serum samples of active TB patients [16]. microenvironment including immune mechanism and apoptosis. Owing Further, six serum micro RNAs hsa-miR-378, hsa-miR-483- 5p, hsa-miR- ∗ Corresponding author. Department of Microbiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, 576104, India. ∗∗ Corresponding author. Department of Cell and Molecular Biology, School of Life Sciences, Manipal Academy of Higher Education, Manipal, 576104, India. E-mail addresses: [email protected] (K. Satyamoorthy), [email protected] (K. Chawla). https://doi.org/10.1016/j.tube.2019.04.002 Received 26 November 2018; Received in revised form 26 February 2019; Accepted 16 April 2019 1472-9792/ © 2019 Published by Elsevier Ltd. S. Chakrabarty, et al. Tuberculosis 116 (2019) 37–43 22, hsa-miR-29c, hsa-miR-101 and hsa-miR-320b have been identified 2.5. Small RNA sequencing as specific markers to discriminate pulmonary TB from healthy controls [17]. Thus, it is evident that further exploration of miRNAs may be The small RNA sequencing was performed in pooled control (n = 2) useful to unravel information on pathophysiology of TB and discovery and pooled extra pulmonary tuberculosis (EPTB) serum samples of specific markers for its diagnosis. Recent reports have suggested that (n = 2). In brief, total RNA from the samples were enriched for small serum derived miRNAs are extremely stable under harsh conditions and RNAs using Total RNA-Seq Kit v2 (ThermoFisher Scientific). The useful as non-invasive biomarkers for early diagnosis of various in- quality and quantity of samples enriched for small RNA were analyzed fectious diseases [17]. In the present study, we performed small RNA using the Agilent small RNA kit (Agilent Technologies, Santa Clara, sequencing and Taqman based qRT-PCR based serum miRNA profiling California, USA) in 2100 Bioanalyzer Instrument. Samples were then of subjects with pulmonary and extrapulmonary tuberculosis in com- barcoded and used for library construction using Total RNA-Seq Kit v2. parison with healthy control. Our study identified a panel of serum Amplification of the templates was performed using Ion OneTouch™ 2 derived circulating host as well as pathogen derived miRNAs which are system and Ion OneTouch™ ES (ThermoFisher Scientific). Enriched differentially expressed during tuberculosis infection. products were loaded onto an Ion 318 chip and run on an Ion PGM system™ (ThermoFisher Scientific). 2. Materials and methods 2.6. Computational and statistical analysis 2.1. Ethical statement BAM files of pooled control and pooled EPTB samples were up- Our study was approved by Kasturba Medical College and Kasturba loaded in CAP-miRSeq pipeline for read pre-processing, alignment, Hospital Institutional Ethics committee, Manipal Academy of Higher distribution of RNA types, and differential miRNA expression analysis Education, Manipal, India. Written informed consent was obtained from [18]. LogFC (log2fold change) > 1 and < -1 were assigned to up- and all subjects prior to their enrolment in the study. down regulated miRNAs with FDR (False Discovery Rate) < 0.05. Targets were predicted using miRDB (Score ≥80) [19], PITA 2.2. Study groups (Score ≤−10) [20], and DIANA microT v4 (Score≥0.9) [21]. Pathway analysis was performed using DIANA miRPath v3.0 [22]. ROC analysis The present study was conducted on 52 individuals divided into was performed for miRNA expression to analyse the diagnostic accu- three groups. Group 1 included 15 TB patients diagnosed based on racy, against pulmonary TB and extra pulmonary TB using MedCalc clinical signs, radiological findings smear microscopy, culture and nu- software. cleic acid amplification tests. Group 2 included 22 Extrapulmonary TB patients diagnosed based 2.7. MTB genome encoded miRNA analysis on clinical signs, radiological/CT findings, MRI, smear microscopy, culture, histopathological findings and nucleic acid amplification tests. The unmapped reads after aligning to the human genome (GRCh37/ Group 3 included 15 normal healthy individuals without any symptoms hg19) were extracted and mapped to Mycobacterium tuberculosis (MTB) of Tuberculosis. (H37Rv). We further identified all small RNA sequencing reads that aligned to MTB genome as potential miRNAs. To validate the same, we 2.3. Sample collection extracted 500 flanking upstream and downstream bases from the mapped coordinates and used a SVM based method to predict pre- Samples from TB and extra pulmonary TB patients were collected miRNAs in the fasta sequence ab-initio. Pre-miRNAs residing between prior to anti-tubercular therapy. Five millilitres of venous blood was 450 and 550 were identified and with a criterion of minimum free withdrawn in a sterile vacutainer from each participant