Long noncoding RNA HULC in acute ischemic stroke: Association with disease risk, severity, and recurrence-free survival and relation with IL-6, ICAM1, miR-9, and miR-195.

Background: This study aimed to evaluate the clinical role of long noncoding RNA (lncRNA) HULC in acute ischemic stroke (AIS).

Methods: LncRNA HULC in plasma samples from 215 first episode AIS patients and 215 age/gender-matched non-AIS controls was detected by reverse transcriptional-quantitative polymerase chain reaction (RT-qPCR). Then, in AIS patients, interleukin-6 and intercellular adhesion molecule 1 (ICAM1), as well as microRNA (miR) target of lncRNA HUCL (miR-9 and miR-195), were detected by enzyme-linked immunosorbent assay and RT-qPCR, respectively. Disease severity was assessed by National Institution of Health stroke scale (NIHSS) score. AIS recurrence or death was recorded, and recurrence-free survival (RFS) was calculated.

Results: LncRNA HULC was increased in AIS patients compared to non-AIS controls (P < .001), and receiver operating characteristic curve showed that it was correlated with increased AIS risk (area under curve: 0.876, 95% confidence interval: 0.843-0.908). Meanwhile, lncRNA HULC was positively correlated with NIHSS score (P < .001, r = .456), interleukin-6 (P < .001, r = .275) and ICAM1 (P < .001, r = .383), whereas negatively correlated with miR-9 (P < .001, r = -.438) but not miR-195 (P = .205, r = -.087) in AIS patients. Additionally, miR-9 was negatively correlated with NIHSS score (P < .001, r = -.335), interleukin-6 (P = .001, r = -.231), and ICAM1 (P < .001, r = -.280), while miR-195 was only negatively associated with NIHSS score (P = .041, r = -.139) in AIS patients. Moreover, lncRNA HULC high expression predicted worse RFS (P = .013) in AIS patients.

Conclusion: LncRNA HULC is correlated with higher AIS risk, increased disease severity and worse prognosis in AIS patients. Meanwhile, it associates with higher IL-6, elevated ICAM1, and lower miR-9 AIS patients.