Exosomal MicroRNA from Blood Plasma as a Predictive Biomarker for Bleeding Tendency in Dengue Infection

Purpose Dengue can manifest as a mild febrile illness to life-threatening haemorrhagic fever. There are currently no predictive markers for individuals prone to bleeding. Therefore, this study aims to investigate the capability of exosomal plasma microRNA (miRNA) expression as a biomarker for bleeding tendency. Methods Microarray was used to profile the miRNAs from plasma exosomes of dengue patients with and without warning sign to find potential biomarkers for bleeding tendency. Predicted target genes were identified using a bioinformatic software and database. miRNA–mRNA interaction network was constructed to identify hub genes. The expression level of miRNAs was validated using RT-qPCR, and its diagnostic performance was assessed using the ROC curve. Finally, functional enrichment pathway analysis, gene ontology and co-expression analysis were performed. Results Microarray profiling revealed 24 upregulated miRNAs with a fold change cut-off value of log2 ≥ 2.0 in the plasma of dengue patients with warning signs compared to those without. Of the upregulated miRNAs, hsa-miR-107 and hsa-miR-6879-5p miRNAs were identified as reliable candidates in predicting bleeding tendency. In silico functional analysis of predicted target genes of these miRNAs suggested their involvement in bleeding manifestation. RT-qPCR analysis showed hsa-miR-107 and hsa-miR-6879-5p were markedly upregulated in dengue patients with warning signs. ROC analysis indicated strong diagnostic potential, and target gene analysis indicated their involvement in platelet dysfunction and vascular processes linked to disease severity. Conclusion This study highlights hsa-miR-107 and hsa-miR-6879-5p expression as promising biomarkers in predicting dengue progression. Further studies could pave the way for improved diagnostic strategies.