In this study, the potential of specific Circular RNAs (circRNAs) as novel peripheral blood biomarkers for myasthenia gravis (MG) was explored. We analyzed circRNAs in the peripheral blood of three normal controls and three MG patients using RNA microarray. Candidate circRNAs were validated in three independent cohorts by Quantitative Real-time polymerase chain reaction (qPCR). Eleven differentially expressed circRNAs were initially identified and four were confirmed in the first independent cohort. Hsa_circ_0076490 and hsa-circ_5333–4 had the largest areas under the curve (AUCs) of the receiver operating characteristics (ROC) and were validated in the second cohort. In the third cohort, hsa-circRNA5333-4 had a larger AUC: 0.864 (95% confidence interval [CI] = 0.801–0.928, P < 0.001), a stronger correlation with the Quantitative Myasthenia Gravis Score (qMG): r = 0.505 (P < 0.001) and was correlated with gender and acetylcholine receptor antibody levels (P < 0.05). So hsa-circRNA5333-4 represents a novel biomarker for the diagnosis and monitoring of MG.

在这项研究中，探索了特定的环状RNA（circRNA）作为重症肌无力（MG）的新型外周血生物标志物的潜力。我们使用RNA微阵列分析了三个正常对照和三个MG患者外周血中的circRNA。通过定量实时聚合酶链反应（qPCR）在三个独立的队列中验证了候选circRNA。最初鉴定出11个差异表达的circRNA，并在第一个独立队列中确认了4个。Hsa_circ_0076490和hsa-circ_5333–4在接收器工作特征（ROC）的曲线下（AUC）具有最大的面积，并在第二个队列中进行了验证。在第三组中，hsa-circRNA5333-4具有较大的AUC：0.864（95％置信区间[CI] = 0.801–0.928，P <0.001），与重症肌无力定量评分（qMG）的相关性更强：r  = 0.505（P <0.001），并且与性别和乙酰胆碱受体抗体水平相关（P  <0.05）。因此，hsa-circRNA533533代表了一种用于MG诊断和监测的新型生物标记。