Project description:Adolescent Idiopathic Scoliosis (AIS) is the most common orthopedic condition requiring surgery, affecting 4% of adolescents. There is currently no proven method or prognostic test to identify symptomatic patients at risk of developing severe scoliosis who could benefit from growth-guided devices or minimally invasive non-fusion instrumentation surgeries. These innovative treatments must be performed at an early disease stage in younger patients to benefit from their growth potential. In this prospective cross-sectional study, we investigated the clinical utility of circulating microRNAs (miRNAs), an important class of small non-coding RNA, as biomarkers to predict the risk of developing severe scoliosis in AIS. Blood samples and clinical data were collected from 116 AIS patients who were followed until skeletal maturity and stratified according to their clinical outcome. Genome-wide expression profiling of miRNAs was performed with plasma obtained at the time of diagnosis of AIS (mean age of 13.3 ± 1.7 years with a mean Cobb angle of 24.4° ± 12.4°). This approach led to the identification of 15 circulating miRNAs that are upregulated in AIS patients who developed a severe scoliosis (Cobb angle ≥45°) at skeletal maturity compared to moderate and mild scoliosis groups (Cobb angle between 25°-44° and <25° respectively). After optimization and the application of Random Forest Models a panel of six miRNAs (miR-1-3p, miR-19a-3p, miR-19b-3p, miR-133b, miR-143-3p, and miR-148b-3p) out of 15 led us to develop an algorithm predicting the risk of developing a severe scoliosis with great accuracy (100%), sensitivity (100%) and specificity (100%). Having a scoliosis predictive bioassay and decision-making tools to predict curve progression in order to find the best treatment plan will undoubtedly transform the orthopedic care system in the field of pediatric scoliosis by integrating innovative precision medicine approaches. In addition, investigation of genes targeted by these miRNAs could fill our gaps in our understanding of AIS pathogenesis and reveal new actionable targets.
Project description:Plasma exosomal miRNA may differ between adolescent idiopathic scoliosis patients and healthy individuals. Sequencing analysis was used to find these differential miRNAs.
Project description:The purpose of the study was to determine differences in mRNA concentration of VDR isoforms in bone, cartilage and paravertebral muscles between tissues from curve concavity and convexity, between JIS and AIS and to identify VDR responsive genes differentiating Juvenile and Adolescent Idiopathic Scoliosis in paravertebral muscles.
Project description:Comparison of paraspinal muscle imbalance between idiopathic scoliosis and congenital scoliosis may shed some light on the causality of paraspinal muscle imbalance and idiopathic scoliosis. This study aims to compare the transcriptomic profiles of paraspinal muscle imbalance between idiopathic scoliosis and congenital scoliosis.
Project description:Introduction: Idiopathic scoliosis (IS) is the most common pediatric spinal deformity, yet no biomarker currently enables early diagnosis or reliable prediction of progression to guide individualized treatment. Circulating microRNAs (miRNAs) are promising non-invasive biomarkers reflecting multifactorial disease mechanisms. Methods: We conducted a prospective study in a Czech cohort comprising 114 pediatric IS patients at the time of diagnosis (82 females, 32 males; median age 13 years, range 7–17) and 89 age-matched healthy controls (60 females, 29 males; median age 13 years, range 7–18). Plasma miRNA profiles were obtained by next-generation sequencing, corrected for batch effect, and analyzed for differential expression. Logistic regression models were used to construct miRNA diagnostic and prognostic signatures, validated by leave-one-out cross-validation (LOOCV). Differential expression analysis identified multiple miRNAs with significant diagnostic potential. A 28-miRNA diagnostic signature distinguished IS patients from controls with AUC = 0.95 and LOOCV accuracy = 0.85, with high PPV and NPV. For prognosis, comparison of high-risk versus low/medium-risk patients revealed a 7-miRNA prognostic signature, achieving AUC = 0.83 and LOOCV accuracy = 0.81. Notably, the incorporation of clinical variables such as age or sex did not improve model performance. Our study demonstrates that circulating miRNA signatures have potential as diagnostic markers and, importantly, as predictors of disease progression in pediatric idiopathic scoliosis. These findings highlight the clinical utility of miRNA-based models for individualized patient management and support further validation in larger, independent cohorts.