Tying malaria and microRNAs: from the biology to future diagnostic perspectives

Symptoms caused by bacterial, viral and malarial infections usually overlap and aetiologic diagnosis is difficult. Patient management in low-resource countries with limited laboratory services has been based predominantly on clinical evaluation and syndromic approaches. However, such clinical assessment has limited accuracy both for identifying the likely aetiological cause and for the early recognition of patients who will progress to serious or fatal disease. Plasma-detectable biomarkers that rapidly and accurately diagnose severe infectious diseases could reduce morbidity and decrease the unnecessary use of usually scarce therapeutic drugs. The discovery of microRNAs (miRNAs) has opened exciting new avenues to identify blood biomarkers of organ-specific injury. This review assesses current knowledge on the relationship between malaria disease and miRNAs, and evaluates how future research might lead to the use of these small molecules for identifying patients with severe malaria disease and facilitate treatment decisions.This work was supported by ISCIII-Subdirección General de Evaluación Plan Nacional I+D+I 2013-2016 (grant PI13/01478 cofunded by the Fondo Europeo de Desarrollo Regional [FEDER] and CES10/021-I3SNS to AM), the Departament d’Universitats i Recerca de la Generalitat de Catalunya (Agencia de Gestión de Ayudas Universitarias y de Investigación (AGAUR); grant 2014SGR263) and the CERCA Institutes Integration Program (SUMA 2013; Secretaría de Universidades e Investigación del Departamento de Economía y Conocimiento de la Generalidad de Cataluña, AGAUR and Fundación Institució dels Centres de Recerca de Catalunya). QB has a fellowship from the programme Miguel Servet of the ISCIII (Plan Nacional de I+D+I 2008-2011, grant number: CP11/00269). XE is supported by the Generalitat de Catalunya AGAUR 2014 SGR-1138 and the Spanish Ministry of Economy and Competitiveness, ‘Centro de Excelencia Severo Ochoa 2013-2017′, SEV-2012-0208