Background
Juvenile spondyloarthropathies (JSpA) are a complex and heterogeneous group of diseases that typically manifest before the age of 16. JSpA is characterized by peripheral joint involvement, axial skeletal involvement, enthesitis, and HLA-B27 positivity. The different subtypes of JSpA include juvenile ankylosing spondylitis, psoriatic arthritis, reactive arthritis, inflammatory bowel disease-associated arthritis, seronegative enthesopathy arthropathy syndrome, and enthesitis-associated arthritis [
1]. Despite significant efforts to understand the pathogenesis and molecular mechanisms of JSpA, they are not yet fully understood [
2]. Therefore, further research is necessary to explore the molecular characteristics and underlying mechanisms of the disease.
Circular RNA (circRNA) is a type of endogenous noncoding RNA that was only recently discovered. These molecules have a covalently closed loop structure and are formed by back splicing. CircRNAs are highly abundant, stable, and exhibit tissue/stage specificity, as well as species conservation [
3]. Recent evidence has suggested that circRNAs have a crucial role in rheumatic diseases, including spondyloarthritis. CircRNAs have been studied as potential diagnostic markers and therapeutic molecules in these diseases. In particular, ceRNA regulation has been found to play an important role in ankylosing spondylitis (AS), which is a subtype of JSpA [
4]. Several studies have investigated the regulatory role of circRNAs in AS, highlighting the potential of these molecules as therapeutic targets for the disease [
5‐
9].
Integrative ceRNA regulatory networks, which incorporate data on circRNA, miRNA, and mRNA, can provide valuable insights into complex gene interactions and help identify potential biomarkers for the diagnosis and treatment of diseases such as JSpA. The Gene Expression Omnibus (GEO) database provides a rich source of RNA sequencing data on circRNA, miRNA, and mRNA, making it an excellent resource for data mining and biological discovery. Constructing integrative ceRNA regulatory networks based on GEO database can lead to the identification of more accurate prognostic markers for JSpA and other diseases. However, few studies have explored the use of GEO database to construct integrative ceRNA regulatory networks, highlighting the need for further research in this area.
In this current research, the GEO database was utilized to identify DEcircRNAs, DEmiRNAs, and DEmRNAs in peripheral blood mononuclear cells (PBMCs) of JSpA patients. Interactions between miRNA-circRNA and miRNA-mRNA were determined using website tools, and a ceRNA network was constructed. Functional enrichment analyses were conducted to assess the biological functions of DEmRNAs, and hub genes were identified through a PPI network. The expression changes in immune cells were assessed using the online CIBERSORTx algorithm, and the proportion of various types of immune cells was determined. Finally, a connectivity map (CMap) analysis was performed to identify potential compounds that could be useful in the treatment of JSpA. The use of GEO databases in this research helped ensure the accuracy and repeatability of the analysis results.
Discussion
The expression patterns of circRNAs have become increasingly noteworthy in various diseases [
21,
22]. A significant proportion of circRNAs are concentrated in peripheral blood, peripheral blood mononuclear cells, platelets, plasma, spinal ligament tissues, and bone marrow-derived mesenchymal stem cells, indicating potential functions in spondyloarthritis. Broadly speaking, the dysregulation of circRNAs may have an impact on fundamental molecular mechanisms that are involved in the development of ankylosing spondylitis (AS) [
23]. Therefore, a more profound comprehension of the role of circRNAs in JSpA is required.
This study aimed to investigate the impact of circRNAs on the pathogenesis and treatment of JSpA. By conducting a microarray data analysis, we established a circRNA-miRNA-mRNA network and identified mRNAs that were significantly altered, enabling us to identify relevant GO terms and the KEGG pathway. Subsequently, we identified hub genes through the use of the PPI network. Additionally, we discovered several effective compounds, which could offer a novel approach to treating JSpA.
Based on the results of our functional enrichment analysis, we propose that in JSpA, the aberrantly expressed circRNAs utilize both protein and RNA binding to affect the regulation of transcription from the RNA polymerase II promoter, transcription and DNA-templated processes, signal transduction, and cell proliferation. Our KEGG pathway analysis indicates that the differentially expressed genes (DEGs) are primarily associated with the JAK-STAT signaling pathway. The JAK/STAT signaling pathway is a widely expressed intracellular signal transduction pathway that plays a critical role in numerous biological processes, such as cell proliferation, differentiation, apoptosis, and immune regulation. It provides a direct mechanism for extracellular factors to regulate gene expression. Recent studies have focused on the inflammatory effects of this pathway [
24], as the JAK-STAT pathways mediate signaling for multiple cytokines, including those implicated in the pathogenesis of spondyloarthritis (SpA) [
25].
Previous studies have shown the significance of circRNAs in the pathogenesis of AS. For example, Wang T et al. identified two down-regulated circRNAs (circPTPN22 and circFCHSD2) and constructed a circRNA-miRNA-mRNA regulatory network based on these two circRNAs [
5]. Additionally, Kou J found that differentially expressed circRNAs play crucial roles in AS and constructed circRNA-miRNA regulatory networks [
6]. Other studies have also demonstrated the involvement of circRNAs in the development of AS. For instance, Song M et al. discovered that hsa_circ_0000652 aggravates inflammation by activating macrophages and enhancing OX40/OX40L interaction in AS [
7]. Tang YP found that hsa_circRNA_012732 has the potential to be an indicator of disease activity, while hsa_circRNA_001544 could serve as a molecular marker for AS diagnosis [
8]. Furthermore, Wang S identified hsa_circ_0070562 as a pro-osteogenic factor in AS [
9].
In our study, we identified five circRNAs (hsa_circ_0006387, hsa_circ_0005070, hsa_circ_0001517, hsa_circ_0005303, hsa_circ_0102537) in the final circRNA-miRNA-mRNA network. To our knowledge, there have been no relevant studies on the potential functions of the top four circRNAs in JSpA or other diseases. However, a study on lung adenocarcinoma (LUAD) identified hsa_circ_0102537 to be downregulated in LUAD plasma exosomes and tissues, suggesting that it could be involved in LUAD progression [
26]. Regarding miRNAs, the seven miRNAs identified in our study have been widely reported in various diseases [
27‐
31]. For example, hsa-miR-1825 was found to be down-regulated in patients with common variable immunodeficiency (CVID) who received Ig infusion [
32], while plasma miR-628-3p was upregulated in atopic dermatitis (AD) patients with severe atopic keratoconjunctivitis (AKC) [
33]. However, except for the above two miRNAs, there have been no relevant studies on the remaining miRNAs in JSpA or other rheumatic immune diseases.
Through CMap analysis, we identified ten drugs (azithromycin, oxybenzone, daunorubicin, losartan, apremilast, A-66, apocynin, trifluoperazine, desmopressin-acetate, and pasireotide) as potential treatment options for JSpA. Previous studies have shown that the PI3K/AKT pathway plays a significant role in the pathogenesis of AS, and the PI3K pathway is highly active in this disease [
34‐
36]. A-66 is a PI3K p110α isoform-selective inhibitor that has been found to inhibit cell growth in melanomas [
37]. Although there are no reports on the effectiveness of A-66 in the treatment of JSpA, we hypothesize that it could be a potential therapeutic option for this disease.
The construction of a circRNA-miRNA-mRNA network in this study has illuminated the regulatory mechanisms of juvenile spondyloarthropathies (JSpA) and has yielded valuable insights into the underlying molecular mechanisms and potential therapeutic targets for this disease. Nevertheless, it is important to acknowledge the limitations inherent in this study. Due to the absence of our own sequencing data, this study relied on existing datasets for analysis, which may have introduced certain limitations and constraints. For example, patients from GSE178408 were not JspA, and three datasets were obtained from different biological tissues or sources. However, this study serves as a springboard for future exploration. It has highlighted the need for subsequent experiments to be conducted in future studies, where independent sequencing data can be generated to further validate and expand upon the findings presented here.
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