Is microRNA-451 expression a useful hemolytic marker in children with β-thalassemia? A pilot study

Background Beta-thalassemia (BT) is the most prevalent inherited hemoglobin disorder in Egypt. MicroRNA-451 (miR-451), an erythroid cell-specific miRNA, is upregulated during erythroid maturation and suggested to be a hemolytic marker. Aim The aim was to investigate plasma miR-451 value as a hemolytic marker, the authors conducted a pilot study on patients with BT attending a hematology clinic in Egypt. Patients and methods The patients with BT were categorized as transfusion dependent (TDT) and nontransfusion-dependent (NTDT). A total of 29 patients were included: 13 TDT (4.5–14.8 years), 16 NTDT (3.2–17.6 years), and 10 controls aged 3–14 years. The miR-451 expression in the plasma of patients was compared with the controls using real-time quantitative polymerase chain reaction. Results Plasma miR-451 expression was higher among patients with BT compared with controls (P=0.272). Similarly, there was a higher expression among the TDT subgroup than the NTDT subgroup (P=0.288). Patients with a severe disease phenotype showed a higher level of miR-451 expression when compared with mild and moderate cases (P=0.301) and among splenectomized patients (P=0.10). Plasma miR-451 did not significantly differentiate between patients with BT and normal controls (area under curve=0.621; P=0.17). In controls, the hemoglobin, red blood cells, and platelet count were significantly correlated with the plasma miR-451 (P=0.03, 0.008, and 0.008, respectively). However, in patients with BT, the alkaline phosphatase significantly correlated with miR-451 (P=0.007). Conclusion The expression of miR-451 was more in patients with TDT than NTDT and controls, but this was not statistically significant. Plasma miR-451 failed to differentiate between controls and patients with BT. More studies are needed to determine its significance in the clinical practice.