Fabry disease is a rare genetic disorder characterized by reduced activity of the enzyme α-galactosidase A, which leads to an accumulation of the enzyme's substrates, resulting in multiple organ systems being affected. Prompt diagnostics, which is crucial due to the progressive development of the disease, is made difficult by the heterogenous clinical picture. The current diagnostics algorithm is based on the measurement of α-galactosidase A activity and GLA gene analysis. Urinary extracellular vesicles originate from the kidneys and contain a cargo, including microRNAs (miRNAs), that reflects physiological and pathophysiological processes in the kidney. MiRNAs from urinary extracellular vesicles therefore present a promising marker for the development and progression of nephropathy in patients with Fabry disease.
The aim of this master’s thesis was to characterize the expression of six miRNAs isolated from urinary extracellular vesicles and to assess their relevance in the development and progression of nephropathy in Fabry patients. Reverse transcription was used to transcribe RNA into complementary DNA, followed by quantitative polymerase chain reaction to determine the expression of miRNAs by real-time measurement of the amplified products.
The study included 33 Fabry patients, nine males and 24 females, and 33 sex- and age-matched control subjects. The expression of six selected miRNAs (miR-15a-5p, miR-30c-5p, miR-30d-5p, miR-221-3p, miR-365a-3p, let-7f-5p) isolated from urinary extracellular vesicles was determined in Fabry patients and control subjects. We found a statistically significant difference in the expression of miR-30d-5p and miR-30c-5p between patients with progressive nephropathy and control subjects, and between patients with progressive nephropathy and patients with stable kidney functions. Due to a high diagnostic efficiency, miR-30d-5p and miR-30c-5p could be used to identify patients with a higher probability of faster progression of nephropathy. In the future, it would be worthwhile to search for additional markers whose expression is already altered before the development of nephropathy. This would allow treatment to be initiated quickly enough to increase the effectiveness of treatment.
|