ArticleJournal of diabetes investigation2026
Targeting the miR-224-5p/PTEN pathway: A previously under-characterized strategy to attenuate mesangial cell injury and predict prognosis in diabetic nephropathy.
Article in Journal of diabetes investigation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
aimTo ascertain the expression status and clinical performance of miR-224-5p in diabetic nephropathy (DN), alongside its molecular mechanism of regulating mesangial cell injury by targeting phosphatase and tensin homolog (PTEN).
methodsSerum miR-224-5p and PTEN mRNA expression were detected in DN patients. Logistic regression was used to analyze independent risk indexes for the poor clinical outcomes in DN. Functional gain/loss and rescue experiments were performed. Target relationships were validated through dual-luciferase reporter assays.
resultsSerum miR-224-5p expression was significantly increased in DN patients (P < 0.001). It displayed moderate diagnostic performance for discriminating DN from T2DM (AUC = 0.796), and good predictive value (AUC = 0.833) for predicting 2-year adverse renal outcomes. MiR-224-5p level was significantly higher in patients with an unfavorable prognosis than those with a favorable prognosis (P < 0.001). Elevated miR-224-5p was identified as an independent risk factor for eGFR decline ≥30% (P = 0.001), but this finding was not applicable to end-stage renal disease (ESRD) due to insufficient case numbers for multivariate analysis. MiR-224-5p inhibition protected high-glucose mesangial cells via PTEN upregulation, an effect reversed by si-PTEN.
conclusionIncreased miR-224-5p expression may serve as a potential circulating biomarker for predicting eGFR decline in DN patients, but these findings are preliminary and require validation in independent cohorts using standardized exogenous spike-in normalization before clinical application. The independence of this association was only demonstrated for the eGFR decline ≥30% endpoint and not for ESRD due to limited statistical power.
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