Circulating miR-155-5p as a Novel Biomarker of Lumbar Degenerative Disc Disease

Srikanth N. Divi*, Dessislava Z. Markova, Taolin Fang, Ryan Guzek, Mark F. Kurd, Jeffrey A. Rihn, Alan S. Hilibrand, David Greg Anderson, Alexander R. Vaccaro, Gregory D. Schroeder, Christopher K. Kepler

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Study Design.Case-control study measuring differential gene expression of circulating microRNA (miRNA) in patients with degenerative disc disease (DDD).Objective.To identify miRNA dysregulation in serum samples of patients with DDD compared to healthy controls (HC).Summary of Background Data.Early DDD can be a difficult diagnosis to make clinically, with lack of positive and specific findings on physical exam or advanced imaging. miRNAs are a class of molecules that act as gene regulators and have been shown to be dysregulated in local degenerative disc tissue. However, to date no studies have identified dysregulation of serum miRNA in patients with DDD.Methods.Whole blood samples were obtained from 69 patients with DDD and 16 HC. Patient-reported outcomes were collected preoperatively and degree of DDD was classified using Pfirrmann grade on preoperative imaging. Differential gene expression analysis using a screening assay for several hundred miRNAs and further characterization for five specific miRNAs (miR-16-5p, miR-21-5p, miR-142-3p, miR-146a-5p, and miR-155-5p) was performed. In addition, a pro-inflammatory cytokine multiplex assay and bioinformatics analysis were done.Results.The initial screening assay showed 13 miRNA molecules that were significantly dysregulated in DDD patients, with miR-155-5p showing significant downregulation (p = 0.027) and direct interactions with the pro-inflammatory cytokine IL-1β, and the tumor suppressor genes p53 and BRAF. Analyzing the whole cohort, miR-155 showed an almost four-fold downregulation in DDD patients (-3.94-fold, P < 0.001) and was the sole miRNA that accurately predicted the presence of disc degeneration (P = 0.006). Downregulation of miR-155 also correlated with increased leg pain (P = 0.018), DDD (P = 0.006), and higher Pfirrmann grade (P = 0.039). On cytokine analysis, TNF-α (0.025) and IL-6 (P < 0.001) were significantly higher in DDD patients.Conclusion.Serum miR-155-5p is significantly downregulated in patients with DDD and may be a diagnostic marker for degenerative spinal disease.Level of Evidence: N/A.

Original languageEnglish (US)
Pages (from-to)E499-E507
Issue number9
StatePublished - 2020
Externally publishedYes


  • apoptosis
  • biomarker
  • degenerative disc disease
  • intervertebral disc degeneration
  • lumbar fusion
  • miR-155-5p
  • nucleus pulposus
  • pfirrmann grade
  • serum cytokines
  • serum miRNA

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine
  • Clinical Neurology

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