Research Progress on The Potential Application of Circular RNA in Systemic Lupus Erythematosus
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摘要: 环状RNA(circular RNA,circRNA)是由pre-mRNA反向剪接形成的1种闭合环状结构的RNA,其在分子特征、生物学功能和调控机制等方面均具有多样性。近年来,人们越来越认识到circRNA在多种人类疾病中发挥作用、并可能作为分子标志物用于预测疾病的诊断及预后,这其中包括经典的自身免疫性疾病——系统性红斑狼疮(systemic lupus erythematosus,SLE)。目前,已发现的部分circRNAs在SLE中表达失调,且可通过不同机制(如“分子海绵”作用、调节信号通路、抑制蛋白激酶激活和诱导细胞凋亡等)促进SLE的发生发展,另外一部分可作为SLE的潜在临床生物标志物,具有应用转化的潜能。就近年来有关circRNA在SLE中的研究展开综述,以期为circRNA在SLE中的后续研究提供科学依据和参考。Abstract: Circular RNA (circRNA), formed by reverse splicing of pre-mRNA, constitutes a closed-loop RNA structure with diversity in molecular characteristics, biological functions, and regulatory mechanisms. In recent years, there has been growing recognition of the roles of circRNA in various human diseases, serving potentially as molecular biomarkers for disease diagnosis and prognosis prediction, including the classical autoimmune disease systemic lupus erythematosus (SLE). Currently, dysregulated expression of some circRNAs has been observed in SLE, which can promote the occurrence and development of SLE through different mechanisms such as "molecular sponge" effects, modulation of signaling pathways, inhibition of protein kinase activation, and induction of cell apoptosis. Another part may serve as potential clinical biomarkers for SLE, holding translational potential. This paper reviews the research on circRNA in SLE over the past years, aiming to provide scientific evidence and references for subsequent studies on circRNA in SLE.
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Key words:
- Circular RNA /
- Systemic lupus erythematosus /
- Biomarkers /
- Molecular mechanisms
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环状RNA(circular RNA,circRNA)是Sanger及其同事研究类病毒时,发现的1种共价封闭的非编码RNA [1],具有多种生物学作用,可通过与miRNA或蛋白质结合,在转录、转录后、翻译或翻译后等阶段发挥功能[2]。系统性红斑狼疮(systemic lupus erythematosus,SLE)是1种慢性自身免疫性疾病,其特征是产生多种自身抗体损伤机体正常组织器官[3],目前虽然已有研究表明SLE与遗传、环境等因素相关,但其具体发病机制尚不清楚[4]。circRNA的环状结构使其稳定性高,且不易被核酸酶降解,因此,在疾病诊疗方面,环状RNA被认为是比线性非编码RNA更好的生物标志物和潜在治疗靶点[5]。现有研究揭示了circRNA在一些常见风湿性疾病发生发展中的作用[6−7]。本文将重点对circRNA在SLE中的研究现状进行综述,旨在为SLE的进一步研究和防治提供参考。
1. circRNA的生物学功能
机体内的前体信使RNA(precursor messenger RNA,pre-mRNA)形成后,可通过常规剪接的方式生成线性mRNA,或通过反向剪接使下游的5'端与上游3'端相连接,形成环状RNA分子[8]。因反向剪接效率较低,大多数被检细胞和组织中的环状RNA丰度也较低[9];但circRNA在人体中分布广泛,且具有组织特异性和结构稳定性,这些特点都使其在疾病诊疗方面展现出巨大潜力[10]。
circRNA的类型比想象的要复杂,内含子序列间的竞争性互补配对,使pre-mRNA可形成3类环状RNA分子,分别是:外显子环状RNA(exonic circRNA,ecircRNA)、内含子环状RNA(intronic circRNA,ciRNA)和外显子-内含子环状RNA(exon-intron circRNA,eIciRNA)[11],目前发现的circRNA主要为ecircRNA,见图1。ciRNA主要定位于细胞核,发挥基因转录调节的作用;ecircRNA主要定位于细胞质,可通过与miRNA结合增加miRNA靶基因的表达水平,发挥“分子海绵”的作用[12]。早年,circRNA被当作是mRNA错误剪接形成的副产物,故其被认为不具有编码蛋白合成的功能[13]。而现有的研究表明,circRNA不仅能编码蛋白质,还能调控细胞间的信号通路。比如,circFBXW7翻译出的短多肽circFBXW7-185AA,可通过N6-甲基腺苷(N6-methyladenosine,m6A)依赖性方式与β-连环蛋白相互作用,最终抑制经典Wnt信号传导的激活[14]。此外,人体内的一些特定circRNA可附着在细胞的DNA上,形成环状RNA-DNA杂合体,进而导致DNA突变,诱导癌症发生[15],这提示人体内的遗传分子可能诱发癌症,而circRNA在这其中起着关键作用。综上所述,circRNA具有以下几种生物学功能:(1)调控基因转录;(2)“分子海绵”作用;(3)调控细胞间信号通路;(4)编码蛋白质;(5)诱导DNA突变。此外,circRNA还可结合和隔离一些特定的蛋白质,以及参与调节某些蛋白间的互作[16−17],以上均说明,circRNA在疾病的发生发展中具有重要生物学意义。
2. circRNA在SLE中的表达谱
一些circRNA的表达被证明在SLE患者和健康人中存在差异。Zheng等[18]发现,SLE患者外周静脉血中has_circRNA_100236、has_circRNA_102489、has_circRNA_101413表达高于健康对照组,且与系统性红斑狼疮疾病活动指数(systematic lupus erythematosus disease activity index,SLEDAI)评分呈正相关。Luo等[19]发现,新发SLE患者血浆样本中hsa_circRNA_0000175、hsa_circRNA_0068367、hsa_circRNA_0044235和hsa_circRNA_0001947 SLE的表达水平明显低于健康对照组,且后两者表达降低是SLE的独立危险因素。此外,hsa_circ_0082688、hsa_circ_0082689和hsa_circ_0008675在50例SLE患者中显著上调,而hsa_circ_0082688和hsa_circ_0082689联合诊断能够有效区分SLE患者、类风湿性关节炎患者(rheumatoid arthritis,RA)和健康人[20]。还有一些circRNA,比如has_circrna_102531、has_circrna_103984、has_circrna_104262在SLE患者血浆中表达升高,而has_circrna_102972、has_circrna_102006、has_circrna_104313在SLE患者血浆中表达降低[21]。除了SLE,circRNA的表达失调在原发性干燥综合征和RA中也有报道。Lu等[22]发现,与SLE患者和健康对照相比,RA患者的外周血单核细胞(peripheral blood mononuclear cells,PBMC)中hsa_circRNA_101328的表达明显下调,且与C反应蛋白阳性之间显著相关。总之,circRNA的表达失调普遍存在于SLE患者中,这些差异表达的circRNA或许参与了SLE的发生发展。
3. circRNA在SLE发生发展中的作用
SLE好发于育龄期女性,该病与遗传、环境、激素、免疫调节等多种因素相关,且尚不能被治愈,其发病机制仍在不断探索中[23]。circRNA已被证实与癌症、心血管疾病、糖尿病,自身免疫性疾病等相关。随着研究的深入,部分circRNA被发现可作为自身免疫性疾病如SLE的临床诊疗生物标志物,有些则与SLE的发病机制密切相关。
3.1 circRNA在SLE疾病进展中的机制
circRNA通过发挥多种生物学作用,如“分子海绵”作用参与SLE的疾病进展。Zhao等[24]发现转录因子c-myb通过正向调节白细胞介素-2受体ɑ亚基(interleukin-2 receptor alpha subunit,IL-2Rɑ)的表达抑制了SLE的进展,而circLOC101928570可作为miR150-5p的海绵增加c-myb的表达,这提示circLOC101928570/ miR-150-5p/c-myb/IL2Rɑ通路可能为SLE发病的潜在机制提供新见解。circMTND5编码于线粒体基因组中,Luan等[25]的研究显示,circMTND5通过海绵化MIR6812可以减轻狼疮肾炎的肾线粒体损伤和肾纤维化,说明靶向circMTND5/ MIR6812轴的治疗或是改善SLE肾损伤的潜在新途径。此外,内源性的circRNA形成的16-26 bp的双链RNA(double stranded RNA,dsRNA)具有抑制细胞中蛋白激酶(protein kinase,PKR)激活的功能,而SLE的PBMC或T细胞中含有短dsRNA的circRNA过表达可减轻PKR的异常激活级联[26]。由于PKR的高表达与SLE相关,circRNA抑制PKR的激活与SLE发病之间可能存在因果关系。
circRNA还能调控信号通路影响SLE的疾病进程。Mei等[27]发现SLE患者体内circRACGAP1的表达下调且该RNA可作为miR-22-3p的海绵,使PTEN/AKT信号通路失活从而阻碍SLE疾病的发展。Guo等[28]的研究表明,circ_0007059可通过靶向miR-1278-SHP-1-STAT3信号通路,减轻干扰素在狼疮肾炎细胞中的炎症作用,提示circ_0007059-miR1278-SHP-1-STAT3调控环与狼疮肾炎的进展相关。Zhang等[29]发现,circETS1能通过miR-1205/FoxP3轴抑制Treg,从而促进SLE活性,这可能成为SLE治疗的新靶点。此外,有学者关注了circRNA在青少年发病的系统性红斑狼疮(juvenile-onset systemic lupus erythematosus,JSLE)中的作用,发现JSLE患者中hsa_circ_0008945水平显著升高,且hsa_ circ_0008945能促进PBMC的凋亡[30],而PBMC的凋亡可能导致免疫复合物沉积,进而攻击机体正常组织。这是circ_0008945在JSLE中的作用首次被研究报道,为青少年SLE的发病机制提供了新的见解。
3.2 circRNA作为SLE的潜在临床生物标志物
通过微阵列分析和实时定量聚合酶链反应(real-time quantitative polymerase chain reaction,RT-qPCR)的实验证明,SLE患者PBMC中显著异常表达的circRNA有1603个,其中hsa_circ_0044235和hsa_circ_0068367在SLE患者中显著降低,进一步的研究验证了上述2种circRNA在SLE和RA患者中具有诊断潜力[31]。Li等[32]发现SLE患者中hsa_circ_0006689的水平下调且与SLEDAI评分相关,进一步地,将该circRNA与抗dsDNA抗体和抗Sm抗体联合诊断还提高了SLE诊断的敏感性,提示hsa_circ_0006689可能是SLE诊断的潜在生物标志物。由于circRNA在SLE儿童中的信息有限,有学者检测了SLE患儿circRNA的表达变化,显示hsa_circ_0057762和hsa_circ_0003090水平可作为SLE患儿与健康对照的鉴别指标,且hsa_circ_0057762水平与SLEDAI-2K分数呈正相关;此外,hsa_circ_0021372和hsa_circ_0075699水平被发现与SLE患儿的补体C3、C4水平相关[33],意味着这2种circRNA或可作为SLE患儿疾病严重程度或全身性炎症的相关生物标志物。通过基因表达综合(gene expression omnibus,GEO)数据库和生物信息学分析软件构建的SLE肾组织circRNA-miRNA-mRNA的调控网络发现,circ-0000006可能是SLE肾脏损伤的新靶点,而miR-766-3p在SLE肾组织中表达升高[34],这为SLE肾损伤提供了潜在治疗靶点,但还需要进一步的实验证实。上述提及的circRNA有望成为SLE诊断预后的新生物标志物,为能够实际应用于临床检测,它们的作用机制还有待进一步的研究。
4. circRNA在SLE研究中的局限和展望
尽管目前关于SLE与circRNA之间的研究众多,但是这些研究有一定的局限性:(1)部分研究中的SLE患者以前接受过治疗,可能影响环状RNA表达谱的分析;(2)有些研究样本量小,而个体间存在差异,这可能使得研究结果不能很好地反应真实水平;(3)关于circRNA作为SLE的诊断预后标志物的敏感性和特异性,有待在临床中验证;且关于circRNA与SLE的研究中,动物实验验证较少。最后,目前大部分研究都集中于circRNA在SLE中的表达情况,机制研究方面集中于“分子海绵”作用,circRNA的其他功能在SLE中的研究较少,如调控基因转录和蛋白互作等,有待进一步的研究来揭示环状RNA在SLE发病机制中的更多可能性。
5. 小结
circRNA的生物学功能十分丰富,在SLE疾病的发展中扮演着重要的角色。研究表明,一些circRNA在SLE患者和健康人群中的表达存在差异,因此有望作为新的生物标志物和诊疗靶点。然而,将这些具有差异表达的circRNA作为SLE疾病的生物标志物时,需要充分考虑其灵敏度和特异性。此外,还应进一步研究其潜在作用机制,以明确这些差异表达的circRNA是否通过某些分子机制参与了SLE的发生和发展。采取针对这些机制的干预措施,可以最大程度地提高差异表达的circRNA作为生物标志物的效用。目前,已有许多关于circRNA在SLE疾病发展中作用机制的研究,相信对这些现有成果的继续深入研究,能够使针对circRNA相关作用机制的策略尽早应用于临床实践中。
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