Background:Diabetic retinopathy (DR) is implicated in blindness of diabetic patients. Earlydiagnosis of DR is very essential to ensure good prognosis. The role of microRNAs (miRs) asbiomarker diagnostic tools in DR is not fully investigated. The present study aimed to findthe relation between serum relative expression of microRNAs (miR-146a, miR-21 and miR-34a) and severity of DR and to what extent their expression pattern can be used as eitherdiagnostic or prognostic.Patients and methods:Eighty type 2 diabetic patients were classified according to severity ofDR into normal, mild, moderate, severe non-proliferative diabetic retinopathy (NPDR) andproliferative diabetic retinopathy (PDR). Serum relative expressions of miRNAs wereevaluated by qPCR and statistically analysed in each stage using Analysis of Variance(ANOVA) followed by Tuckey-Kramer post-test.Results:Serum relative expressions of miR-146a and miR-21 were increased with increasedseverity of DR. miR-34a decreased with the severity of DR. The expression pattern in eachgroup in relation to normal fundus group could be diagnostic and prognostic where miR-146a was only increased in mild group and continued with the severity. In moderategroup miR-21 start to increase along with slight decrease in miR-34a. In severe NPDR groupalong with highly increased levels of both miR-146a and miR-21, a marked decrease in miR-34a. In PDR group miR-34a was almost diminished along with very high levels of both miR-146a and miR-21.Q2Conclusions:miRs (146a,-21 and-34a) are promising biomarkers in DR and can help toavoid disease progression.Diabetes mellitus (DM) affects>350 million people worldwideand makes a considerable contribution to morbidity andmortality globally [1]. DM is a major emerging clinical andpublic health problem in Egypt with a prevalence of 5e10% inthe 1990s [2]. It has been estimated that by the year 2025,nearly over 13% of the population over 20 years of age will*Corresponding author.E-mail address:goudahelal@gmail.com(H.G. Helal).Peer review under responsibility of Chang Gung University.Available online atwww.sciencedirect.comScienceDirectBiomedical Journaljournal homepage:www.elsevier.com/locate/bj123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100101102103104105106107108109110111112113114115116117118119120121122123124125126127128129biomedical journal xxx (xxxx) xxxBJ366_proof■10 November 2020■1/10https://doi.org/10.1016/j.bj.2020.11.0032319-4170/©2020 Chang Gung University. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-NDlicense (http://creativecommons.org/licenses/by-nc-nd/4.0/).Please cite this article as: Helal HG et al., MicroRNAs (146a,21 and34a) are diagnostic and prognostic biomarkers for diabeticretinopathy, Biomedical Journal, https://doi.org/10.1016/j.bj.2020.11.003
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