Exploring the Diagnostic Potential of Parasite‐Derived <scp>miRNAs</scp> in Cystic Echinococcosis: Are We Getting Closer?

Cystic echinococcosis (CE) is the neglected zoonotic illness caused by a parasite. Non-invasive imaging methods, most notably ultrasound, are used in clinical practice to diagnose CE. Small, non-coding RNA molecules known as microRNAs (miRNAs) function as post-transcriptional regulators in various biological processes. The identification of parasite-derived miRNAs has raised significant interest, as these molecules hold promise as potential biomarkers for CE diagnosis and subsequent monitoring. This study investigates the diagnostic potential of certain parasite-derived miRNAs namely egr-let-7-5p, egr-miR-71-5p, egr-miR-61-5p, egr-miR-10-5p, and egr-miR-9-5p, to differentiate patients with CE from healthy individuals and those with other parasitic infections. The study involved the analysis of serum samples from 83 CE patients, 95 individuals with other parasitic diseases, and 75 healthy controls. Except for egr-let-7-5p, all tested parasite-derived miRNAs effectively distinguished CE patients from healthy controls, with egr-miR-71-5p (AUC: 0.860, p < 0.001) showing the best performance, with a sensitivity of 0.810, and a specificity of 0.784. Despite the overall discriminatory power of miRNAs, only egr-miR-9-5p (AUC value: 0.649, p < 0.01) showed a significant ability to differentiate CE patients from those with other parasitic diseases, with a sensitivity of 0.580 and specificity of 0.711. Additionally, none of the parasite-derived miRNAs demonstrated significant success in distinguishing between active and inactive CE cysts. This study stands out as the most extensive evaluation to date of parasite-derived miRNA biomarkers for CE patients, representing a major step forward in diagnostic research for this zoonotic disease, which often faces diagnostic uncertainty and lacks robust laboratory methods.