Investigation on the clinical potential of miR-193a-3p in carotid artery stenosis and its mechanism in regulating oxidized low-density lipoprotein-induced human vascular smooth muscle cells

Q: What are the key findings of this study?

High serum miR-193a-3p expression independently predicted cerebral ischemic events in carotid artery stenosis patients and distinguished CAS from controls.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Carotid artery stenosis (CAS) (n=192). Intervention: High serum miR-193a-3p expression vs. Low serum miR-193a-3p expression (and healthy controls for diagnostic comparison). Primary outcome: Occurrence of cerebral ischemic events (CIEs) among patients with carotid artery stenosis over a median 60-month follow-up (HR 3.217, 95% CI 1.246-8.304, p=0.016).

Q: What does this research mean for the field?

Upregulated miR-193a-3p serves as a diagnostic and prognostic biomarker for carotid artery stenosis and promotes vascular smooth muscle cell injury and phenotype switching by targeting LAMC1. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

Duan Liu; Yawen Zhang; Liang Zhu

doi:10.1186/s12872-026-06519-9

September 2, 2026BMC Cardiovascular DisordersOpen Access

Investigation on the clinical potential of miR-193a-3p in carotid artery stenosis and its mechanism in regulating oxidized low-density lipoprotein-induced human vascular smooth muscle cells

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Key result

Elevated miR-193a-3p linked to ~3.2-fold higher risk of cerebral ischemic events in carotid stenosis.

HR 3.217
95% CI 1.246-8.304
P=0.016
n=192

Why the study?

Does elevated serum miR-193a-3p expression diagnose carotid artery stenosis and predict cerebral ischemic events in patients with carotid artery stenosis?

Key Points

To investigate the diagnostic and prognostic value of serum miR-193a-3p in carotid artery stenosis and evaluate its molecular mechanisms in oxidized low-density lipoprotein-induced human vascular smooth muscle cells.
Measured serum miR-193a-3p levels by RT-qPCR in 107 subjects with carotid artery stenosis (mild: 37, moderate: 51, severe: 19) and healthy individuals, evaluating diagnostic and prognostic efficacy via ROC and Cox regression across a median 60-month follow-up.
Cultured ox-LDL-stimulated human vascular smooth muscle cells transfected with miR-193a-3p inhibitors or mimics and LAMC1 silencing vectors to evaluate proliferation, migration, inflammation, oxidative stress, and phenotype switching.
Serum miR-193a-3p was upregulated in patients with carotid artery stenosis (p < 0.001), distinguishing them from healthy controls with an AUC of 0.839 (95% CI: 0.783–0.895), and effectively differentiating mild from moderate (AUC = 0.822) and severe stenosis (AUC = 0.895).
High miR-193a-3p expression predicted risk of carotid artery stenosis (OR: 4.544) and served as an independent predictor of cerebral ischemic events (HR: 3.217).
In vitro, miR-193a-3p directly targeted LAMC1; suppressing miR-193a-3p reduced cell proliferation, migration, IL-6, TNF-α, and MDA while increasing SOD and contractile phenotype marker α-SMA, which was counteracted by LAMC1 knockdown.

Study Design

Type

Cohort (n=192)

Multicenter

No

Structured PICO

Does elevated serum miR-193a-3p expression diagnose carotid artery stenosis and predict cerebral ischemic events in patients with carotid artery stenosis?

P

Population

107 adults with carotid artery stenosis (mean age 62.91 years, 38.32% female) free of prior stroke or TIA and 85 healthy controls (total N=192) at a single center in China, with CAS patients followed for a median of 60 months.

E

Exposure

High serum miR-193a-3p expression (above mean cutoff, n=54 in CAS cohort) measured by RT-qPCR; in vitro transfection with miR-193a-3p mimic (50 nM), miR-193a-3p inhibitor (100 nM), or LAMC1 siRNA (50 nM) in ox-LDL-treated hVSMCs.

C

Comparator

Low serum miR-193a-3p expression (below mean cutoff, n=53 in CAS cohort) for prognostic analysis, and healthy controls (n=85) for diagnostic analysis; negative control transfections (mimic NC, inhibitor NC, si NC) in vitro.

O

Outcome

Prognostic occurrence of cerebral ischemic events (CIEs) over a median 60-month (5-year) follow-up, and diagnostic discrimination of CAS from healthy controls and across CAS severity grades.hard clinical

Main Result

Hazard Ratio: 3.217 (95% CI 1.246–8.304)

p-value: p=0.016

Limitations

Single-center study requiring external validation in independent cohorts from other hospitals or regions
Cross-sectional assessment of miR-193a-3p expression at a single time point lacking longitudinal dynamic tracking
Mechanistic validation was limited to in vitro ox-LDL-induced hVSMC experiments without in vivo animal models
Potential downstream signaling pathways mediated by the miR-193a-3p/LAMC1 axis remain unexplored
Single-center study requiring external validation in independent cohorts
Cross-sectional measurement of miR-193a-3p at a single time point without longitudinal tracking of dynamic changes
Regulatory mechanism was only validated in vitro in ox-LDL-induced hVSMCs without in vivo animal models
Downstream signaling pathways mediated by the miR-193a-3p/LAMC1 axis remain unexplored

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Implication

Serum miR-193a-3p is a promising diagnostic and prognostic biomarker for carotid artery stenosis severity and future cerebral ischemic events, acting mechanistically by targeting LAMC1 to promote vascular smooth muscle cell injury and phenotypic switching.

Abstract

Given the numerous advantages of microRNAs as biomarkers in diseases, this study investigated the role of miR-193a-3p in carotid artery stenosis (CAS), aiming to provide novel biomarkers for CAS clinical management. RT-qPCR measured serum miR‑193a‑3p expression in 107 CAS subjects and 85 healthy individuals. The diagnostic and prognostic potential of miR-193a-3p in CAS was evaluated by ROC curve, logistic regression analysis, Kaplan‑Meier and COX regression analysis. The involvement of miR-193a-3p in ox-LDL-induced human vascular smooth muscle cells (hVSMCs) was evaluated through cell counting kit-8, transwell, enzyme-linked immunosorbent assay kits and phenotype switching markers. Bioinformatics and dual‑luciferase reporter assay validated downstream targets. Rescue experiments assessed the effect of miR-193a-3p/LAMC1 axis-mediated regulation in ox-LDL-induced hVSMCs. Upregulated miR‑193a‑3p expression was observed in CAS group and distinguished CAS from healthy individuals (AUC = 0.839) and differentiated stenosis severity (mild vs. moderate: AUC = 0.822; mild vs. severe: AUC = 0.895). High miR‑193a‑3p expression predicted the occurrence of cerebral ischemic events (CIEs) among subjects with CAS. In vitro, miR‑193a‑3p inhibition reduced cell proliferation, migration, inflammation (decreased IL-6 and TNF-α) and oxidative stress (diminished MDA, enhanced SOD), and reversed phenotype switching (upregulated α-SMA, downregulated osteopontin) in ox‑LDL‑induced hVSMCs. LAMC1 was confirmed as the target, and the above effects of miR‑193a‑3p suppression were counteracted by silencing LAMC1. Upregulated miR-193a-3p expression in CAS showed diagnostic and prognostic potential for CAS. In vitro, miR-193a-3p regulated the cell injury and phenotype switch through targeting LAMC1 in ox-LDL-stimulated hVSMCs, suggesting a novel insight for CAS clinical treatment.

Discussion

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Cite This Study

Liu et al. (2026) conducted a cohort in Carotid artery stenosis (CAS) (n=192). High serum miR-193a-3p expression vs. Low serum miR-193a-3p expression (and healthy controls for diagnostic comparison) was evaluated on Occurrence of cerebral ischemic events (CIEs) among patients with carotid artery stenosis over a median 60-month follow-up (HR 3.217, 95% CI 1.246-8.304, p=0.016). High serum miR-193a-3p expression independently predicted cerebral ischemic events in carotid artery stenosis patients and distinguished CAS from controls.

synapsesocial.com/papers/6a9a85b05d9e33f25c631145 https://doi.org/10.1186/s12872-026-06519-9

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Investigation on the clinical potential of miR-193a-3p in carotid artery stenosis and its mechanism in regulating oxidized low-density lipoprotein-induced human vascular smooth muscle cells

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Investigation on the clinical potential of miR-193a-3p in carotid artery stenosis and its mechanism in regulating oxidized low-density lipoprotein-induced human vascular smooth muscle cells

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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