Serum miR-181a-2-3p serves as a diagnostic biomarker for sepsis and its predictive value for clinical outcomes

Sepsis remains a critical clinical challenge with high mortality. Uncovering reliable biomarkers and key regulatory mechanisms is crucial for early diagnosis and prognosis improvement. Serum miR-181a-2-3p was detected via RT-qPCR in 167 sepsis patients and 103 healthy controls (HC). The relationship of this miRNA to conventional diagnostic markers for sepsis was evaluated by employing Pearson and Spearman correlation methods. ROC curves evaluated the diagnostic efficacy of this miRNA and TMEM173. The prognostic value of miR-181a-2-3p was evaluated by Kaplan-Meier and Cox regression analyses. The functional targeting effect of miR-181a-2-3p on TMEM173 was confirmed by dual luciferase reporter assay. A sepsis model was established using LPS-stimulated THP-1 cells. Cell proliferation was assessed using the CCK-8 assay. Inflammatory cytokine concentrations were measured via ELISA. Serum miR-181a-2-3p was lower in sepsis patients than in HC. Among septic patients, miR-181a-2-3p expression was inversely associated with PCT, CRP, APACHE II, and SOFA scores. In addition, low expression levels of this miRNA were independently associated with poor prognosis. TMEM173 levels were up-regulated in sepsis patients, effectively distinguishing them from HC. Furthermore, miR-181a-2-3p may contribute to the progression of sepsis by regulating the cGAS-STING and NF-κB signaling pathways via TMEM173. Serum miR-181a-2-3p had diagnostic and prognostic value for sepsis. miR-181a-2-3p may exert a protective effect in sepsis by targeting TMEM173.