Analysis of hsa_circ_0136256 as a biomarker for fibrosis in systemic sclerosis.

Background: Exploration of whether circRNAs in the skin of systemic sclerosis (SSc) model mice interact with 4E-BP1 protein to mediate the mTOR signaling pathway to regulate SSc fibrosis is crucial to identify homologous human circRNAs as markers to guide the diagnosis and treatment of SSc.

Methods: C57BL/6 mice aged 6-8 weeks and weighing approximately 20 g were subcutaneously injected with bleomycin (BLM) to establish an SSc model. High-throughput sequencing was used to screen the differentially expressed circRNA in the skin of SSc model mice and control mice. RNA immunoprecipitation and RNA pulldown confirmed the interaction between circRNA and 4E-BP1 protein. SSc model mice were treated with empty plasmid (OE-NC), overexpression plasmid of mmu_circ_0005372 (OE-circ_0005372), interference plasmid of mmu_circ_0005372 (sh-circ5372), mutant plasmid of mmu_circ_0005372 (circ5372-MT), mTOR activator (MHY1485), mTOR inhibitor (omipalisib), or JAK1/2 inhibitor (ruxolitinib). Sections of mouse skin tissue were stained with Hematoxylin and eosin and Masson's stain. The collagen volume fraction (CVF) was calculated as CVF = area of blue collagen/total area with ImageJ. The correlation between homologous human circRNAs and clinical data was analyzed.

Results: Compared to the control group, 21,839 circRNAs were upregulated and 27, 946 circRNAs were downregulated in the skin tissue of mice in the SSc model group. Among them was mmu_circ_0005372, which is derived from the FZD3 gene, is closely related to fibrosis, and is involved in the mTOR signaling pathway. Hsa_circ_0136256 was identified as the homologous human circRNA of mmu_circ_0005372. RT-qPCR confirmed that the expression of mmu_circ_0005372 was significantly reduced in the skin tissue of SSc mice, and the expression of hsa_circ_0136256 was significantly reduced in the peripheral blood mononuclear cells of patients with SSc. The interaction between mmu_circ_0005372 and 4E-BP1 protein was inhibited in the skin tissue of SSc model mice. The results showed that the CVF of OE-circ_0005372 group was significantly lower than that of the sh-circ5372, circ5372-MT, and MHY1485 groups, indicating that OE-circ5372 significantly improved skin fibrosis in the SSc mice. ROC curve analysis was performed on hsa_circ_0136256 (AUC = 0.719, P = 0.035). The expression of hsa_circ_0136256 was negatively correlated with COL IV, RDW-SD, and RDW-CV, and positively correlated with VC, PLT, and PCT. The results suggested that hsa_circ_0136256 may have important roles in the clinical diagnosis of SSc.

Conclusion: Mmu_circ_0005372 and homologous human hsa_circ_0136256 may be biomarkers and therapeutic targets for SSc fibrosis.