Evaluation of hsa-miR-29a-3p expression and diazepam biotransformation via CYP2C19 in alcohol withdrawal syndrome.

This study investigated whether hsa-miR-29a-3p expression affects diazepam (DZP) metabolism by modulating CYP2C19 gene expression in patients with alcohol withdrawal syndrome (AWS). Blood samples were obtained from 75 male AWS patients. hsa-miR-29a-3p expression was quantified using qRT-PCR, and plasma DZP and its active metabolite nordiazepam (NDZP) levels were measured via HPLC. No significant correlations were found between hsa-miR-29a-3p expression and DZP dose, plasma DZP/NDZP levels, dose-adjusted or weight-adjusted concentrations, or the metabolite-to-parent drug ratio. However, hsa-miR-29a-3p expression levels were significantly higher in patients exhibiting confusion (p = 0.016) and excessive fatigue (p = 0.039). Although hsa-miR-29a-3p did not appear to influence diazepam biotransformation directly, this study is the first to report a potential link between elevated hsa-miR-29a-3p expression and neuropsychiatric symptoms in AWS, suggesting a possible role of this microRNA in the clinical presentation of alcohol withdrawal.