MiR-34a is differentially expressed in dorsal root ganglia in a rat model of chronic neuropathic pain.

INTRODUCTION: Recent evidence shows that numerous microRNAs (miRNAs) regulate pain-related genes in chronic pain. The aim of the present study was to further explore the regulation of miRNAs and their effect on the expression of pain-associated target genes in experimental neuropathic pain. METHODS: Male Wistar rats underwent chronic constriction injury (CCI) of the sciatic nerve or Sham procedure. After assessment of mechanical allodynia, the ipsilateral dorsal root ganglia (DRG) were harvested. MiRNA expression levels were analysed with Agilent microRNA microarrays and real time quantitative PCR. An interaction between miRNAs and pain-relevant genes was confirmed by luciferase assays. Western Blot analysis and ELISA were performed to evaluate protein expression, respectively. RESULTS: Mechanical allodynia developed within 6 days after CCI. MiRNA-arrays revealed the differential expression of 49 miRNAs after 4 h, of 3 miRNAs after 1 d, of 26 miRNAs after 6 d and of 28 miRNAs after 12 d in the CCI group versus Sham. Time-dependent down regulation of miR-34a was verified by qPCR. Bioinformatic prediction revealed an interaction with several pain-relevant targets including voltage-gated sodium channel ß2 subunit (SCN2B) and vesicle-associated membrane protein 2 (VAMP-2), both of which were subsequently confirmed by luciferase assay. VAMP-2 expression was statistically significantly increased 12 d after CCI. A non-significant upregulation of SCN2B in the DRG after CCI was confirmed by ELISA. DISCUSSION: Peripheral mononeuropathic pain in rats was associated with distinct alterations of miRNA expression in the ipsilateral DRG. Notably, miR-34a was time-dependently down regulated. We validated SCN2B and VAMP-2 as new targets of miR-34a. While SCN2B expression was only marginally altered, VAMP-2 expression was increased. The present study underlines that the induction and maintenance of neuropathic pain is accompanied by expression changes of miRNAs in the peripheral nervous system, adding several previously unreported miRNAs, including miR-34a.

Genetics of acute myeloid leukemia in the elderly: mutation spectrum and clinical impact in intensively treated patients aged 75 years or older.

A cute myeloid leukemia is a disease of the elderly (median age at diagnosis, 65-70 years). The prognosis of older acute myeloid leukemia patients is generally poor. While genetic markers have become important tools for risk stratification and treatment selection in young and middle-aged patients, their applicability in very old patients is less clear. We sought to validate existing genetic risk classification systems and identify additional factors associated with outcomes in intensively treated patients aged ≥75 years. In 151 patients who received induction chemotherapy in the AMLCG-1999 trial, we investigated recurrently mutated genes using a targeted sequencing assay covering 64 genes. The median number of mutated genes per patient was four. The most commonly mutated genes were TET2 (42%), DNMT3A (35%), NPM1 (32%), SRSF2 (25%) and ASXL1 (21%). The complete remission rate was 44% and the 3-year survival was 21% for the entire cohort. While adverse-risk cytogenetics (MRC classification) were associated with shorter overall survival (P=0.001), NPM1 and FLT3-ITD mutations (present in 18%) did not have a significant impact on overall survival. Notably, none of the 13 IDH1-mutated patients (9%) reached complete remission. Consequently, the overall survival of this subgroup was significantly shorter than that of IDH1-wildtype patients (P<0.001). In summary, even among very old, intensively treated, acute myeloid leukemia patients, adverse-risk cytogenetics predict inferior survival. The spectrum and relevance of driver gene mutations in elderly patients differs from that in younger patients. Our data implicate IDH1 mutations as a novel marker for chemorefractory disease and inferior prognosis. (AMLCG-1999 trial: clinicaltrials.gov identifier, NCT00266136).