The role of miRNA expression in the pathogenesis of early stages of Retinopathy of Prematurity: Pilot Study

Background: Retinopathy of Prematurity (ROP) is a multifactorial disease affecting premature infants, characterized by abnormal retinal vascular development due to fluctuations in oxygen exposure. Recent research has highlighted the role of microRNAs (miRNAs) in angiogenesis and retinal diseases, yet their involvement in early-stage ROP remains unclear. Objective: This pilot study aims to investigate the expression patterns of specific miRNAs in preterm infants with early-stage ROP (maximum stage 2) who did not require therapeutic intervention. By evaluating selected miRNAs, this study seeks to understand their potential role as biomarkers in the pathogenesis of mild ROP. Methods: A prospective observational study was conducted on preterm infants born before 32 weeks of gestation and weighing less than 1500 grams. Blood samples were collected at birth and analyzed for miRNA expression using quantitative PCR. Five miRNAs previously associated with angiogenesis—miR-210, miR-21, miR-27b, miR-214, and miR-128a—were selected based on existing literature. Statistical analysis was performed to compare expression levels between infants with and without ROP. Results: Significant differences in miRNA expression were observed between the ROP and control groups. miR-210, miR-21, miR-214, and miR-27b were downregulated in ROP patients, while miR-128a was upregulated. miR-210 levels correlated positively with oxygen exposure duration, suggesting its potential as a marker of prolonged hypoxic insult. These findings indicate that miRNA dysregulation may play a crucial role in early-stage ROP. Conclusions: This study provides preliminary evidence of miRNA involvement in the pathogenesis of mild ROP. The differential expression of miR-210, miR-21, miR-214, miR-27b, and miR-128a suggests their potential use as early biomarkers for ROP screening and risk assessment. Further studies with larger cohorts are needed to validate these findings and explore their therapeutic implications.