title: The role of miRNA-34a as a prognostic biomarker for cirrhotic patients with portal hypertension receiving TIPS.
abstract: BACKGROUND
  Circulating miRNA-34a is increased in blood of patients with different liver diseases when compared to healthy controls. However, the origin of miRNA-34a and its possible relationship with hemodynamics and outcome in cirrhotic patients with portal hypertension is unknown. We analyzed the levels of miRNA-34a in cirrhotic patients with severe portal hypertension.
  
  
  METHODS
  We included 60 cirrhotic patients receiving TIPS for prevention of rebleeding and/or therapy-refractory ascites. miRNA-34a levels were measured using qPCR and normalized by SV-40 in the portal and hepatic venous blood of these patients taken at TIPS procedure. Hemodynamic and clinical parameters were assessed before TIPS and during follow-up.
  
  
  RESULTS
  Levels of miRNA-34a were higher in the hepatic vein than in the portal vein. Circulating miRNA-34a in the hepatic vein correlated with ALT, CHE and sodium excretion after TIPS. miRNA-34a showed no correlation with portal pressure, but its levels in the portal vein correlated inversely with the congestion index. Interestingly, the levels of miRNA-34a in the portal and hepatic vein showed inverse correlation with arterial pressure. Furthermore, levels of miRNA-34a in the hepatic vein had a predictive value for survival, but MELD, creatinine at short-time follow-up 14 days after TIPS-insertion and portal pressure after TIPS performed better.
  
  
  CONCLUSIONS
  This study demonstrates for the first time, that miRNA-34a may originate to a large extent from the liver. Even though higher levels of miRNA-34a are possibly associated with better survival at long-term follow-up in cirrhotic patients with severe portal hypertension receiving TIPS, classical prognostic parameters predict the survival better.
authors: Department of Internal Medicine I, University of Bonn, Bonn, Germany.
authors: Christian
authors: C
authors: Jansen
authors: Department of Pathology, University of Cologne, Cologne, Germany.
authors: Hannah
authors: H
authors: Eischeid
authors: Department of Internal Medicine I, University of Bonn, Bonn, Germany.
authors: Jan
authors: J
authors: Goertzen
authors: Department of Internal Medicine I, University of Bonn, Bonn, Germany.
authors: Robert
authors: R
authors: Schierwagen
authors: Department of Internal Medicine I, University of Bonn, Bonn, Germany.
authors: Evrim
authors: E
authors: Anadol
authors: Department of Internal Medicine I, University of Bonn, Bonn, Germany.
authors: Christian P
authors: CP
authors: Strassburg
authors: Department of Internal Medicine I, University of Bonn, Bonn, Germany.
authors: Tilman
authors: T
authors: Sauerbruch
authors: Department of Pathology, University of Cologne, Cologne, Germany.
authors: Margarete
authors: M
authors: Odenthal
authors: Department of Internal Medicine I, University of Bonn, Bonn, Germany.
authors: Jonel
authors: J
authors: Trebicka
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D005260:Female; D015870:Gene Expression; D006503:Hepatic Veins / Q000378:metabolism; D006801:Humans; D006975:Hypertension, Portal / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000235:genetics / Q000601:surgery; D008297:Male; D035683:MicroRNAs / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data; D011169:Portal Vein / Q000378:metabolism; D019168:Portasystemic Shunt, Transjugular Intrahepatic; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D015415:Biomarkers; C522425:MIRN34 microRNA, human; D035683:MicroRNAs