A blood-based co-expression signature of LncRNAs and transcription factors in neuromyelitis optica with diagnostic and mechanistic implications.

Neuromyelitis optica (NMO) is an autoimmune disease that mainly affects the optic nerves and spinal cord. This disorder has been associated with dysregulation of several transcripts. We aimed to find possible peripheral markers for NMO through expression analysis of NF-κB-associated transcripts. Thus, we assessed expression of seven NF-κB-associated transcripts (including lncRNAs and mRNAs), namely ADINR, ANRIL, NKILA, PACER, DICER-AS, DILC, and CEBPA in the blood samples of NMO patients and healthy subjects. All seven transcripts demonstrated evidently higher expression in NMO patients compared with controls. The most prominent over-expression belonged to DICER-AS, followed by ADINR, PACER, NKILA, ANRIL, CEBPA, and DILC. All comparisons were statistically significant at P ≤ 0.0001, except DILC, which remained highly significant (P = 0.0001). Based on the ROC curve analyses, several transcripts, particularly, ADINR and DICER-AS could discriminate NMO patients from controls. The correlation in the expression of mentioned genes suggest a possible co-regulated lncRNA–transcription factor module in the blood of NMO patients that probably unites on NF-κB, IL-6/STAT3 and myeloid regulatory pathways. Taken together, these transcripts might be used in future biomarker discovery attempts for NMO in larger cohorts of NMO patients and controls.