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Neonatal sepsis is a major health concern among neonates with higher morbidity and mortality rate. Studies have recently speculated the importance of differential expression of circulating mature micro-RNAs (miRNAs) which could serve as diagnostic as well as prognostic markers for risk of mortality in neonatal sepsis. This study aimed to analyze the expression pattern and to assess the diagnostic/prognostic value of miRNAs  miR-21, miR-29a miR-31, miR-146a , and  miR-155  in late-onset neonatal sepsis. A cross-sectional comparative study was conducted including 42 healthy controls and 42 neonates with late-onset neonatal sepsis. SYBR green-based miScript RT-PCR assay was used for the expression analysis and the comparative Ct method 2-delta (Ct) method was used for relative quantification of the candidate miRNAs in plasma. Significantly higher expression of  miR-21  and  miR-155  and lower expression of  miR-29a  and  miR-146a  was observed in cases compared to control except  miR-31 . In subgroups analysis, miR-21( p  = .03) showed a significant difference between pre-term and term neonates and miR-31 ( p  = .01) and miR-155 ( p  = .03) showed a significant difference between low-birth-weight and normal-birth-weight neonates.  miR-146a  showed significantly lower expression in the non-survivor group compared to the survivor group ( p  = .005). A receiver operating characteristic curve (ROC) analysis of  miR-21  and  miR-29a  (0.829 and 0.787 AUC of ROC curves) showed good discrimination for the identification of sepsis from non-sepsis neonates. The current study shows evidence of differential expression of miRNAs in neonatal sepsis and this altered expression of candidate miRNAs could be involved in immune dysregulation, thus leading to sepsis-related severity in newborns.

MicroRNA Expression in Neonates with Late-onset Sepsis – A Cross-sectional Comparative Study