High expression of miR-221-3p may increase the risk of perioperative respiratory adverse events in children undergoing general anesthesia

This is the authors' abstract. We don't add key points for this paper.

Current perioperative respiratory adverse events (PRAE) prediction relies on subjective clinical factors, facing a shortage of objective biomarkers. To this end, the present study sought to investigate miR-221-3p in PRAE and assess its clinical relevance, while exploring its role in airway inflammation by targeting ETS1. A total of 194 pediatric patients requiring general anesthesia were enrolled and grouped based on the occurrence of PRAE. All patients were analyzed for miR-221-3p and ETS1 levels using RT-qPCR. ROC curves and multivariate logistic regression analysis were utilized to evaluate its clinical value. Besides, an airway inflammation model was established by stimulating HPMECs with LPS. Cell proliferation, apoptosis, and inflammatory factors were assessed using the CCK-8 assay, flow cytometry, and ELISA, respectively. Markedly elevated postoperative serum miR-221-3p was observed in children with PRAE. The postoperative serum miR-221-3p exhibited exploratory discriminatory performance for PRAE (AUC > 0.8); however, since blood samples were collected only after surgery, the preoperative predictive value of this association could not be established. Higher postoperative miR-221-3p levels were associated with an increased risk of PRAE. Higher miR‑221‑3p levels were associated with an increased risk of PRAE. Knocking down miR-221-3p increased ETS1 levels, promoted cell proliferation, inhibited apoptosis, and reduced damage. Postoperative serum miR-221-3p is associated with increased PRAE risk in children and may promote airway inflammation by negatively regulating ETS1. These findings remain exploratory, and preoperative predictive value is unestablished; longitudinal preoperative/postoperative studies are needed. Not applicable.