Development of serum exosomal miRNA signatures for persistent organ failures in early-phase of acute pancreatitis

To identify and assess exosomal miRNA signatures with potential to predict individuals with persistent organ failure (POF) at early phase of acute pancreatitis. We analyzed serum collected from 790 AP patients. In discovery cohort, we profiled exosomal miRNAs in sera sampled from AP patients with or without POF (5 vs. 5) using microarrays and identified a list of miRNAs with increased expression pattern. Of notes, 10 AP samples with/without POF are collected within 24 hours after AP onset and later did/didn’t develop POF. We further constructed a miRNA classifier (Cmi) through logistic regression and identified certain individual miRNAs (OR>2) as candidate predictive markers in the training cohort of 227 AP samples. Predictive performance of these markers were validated in three independent cohorts (255, 226 and 78 AP samples respectively). Ten serum samples were collected from AP patients within 24 hours after AP onset. Five cases later developed POF (POF group), while the other five did not (No POF group). Exosomal miRNAs were extracted and quantified in each group for potential markers for POF prediction.