Diagnostic value of long noncoding RNAs as biomarkers for Ankylosing Spondylitis: A systematic review and meta-analysis

Introduction: Ankylosing spondylitis (AS) presents as a debilitating form of arthritis with potential for severe damage. In chronic cases, patients may experience progression to ankylosis and spinal immobility, significantly diminishing their quality of life. Given these challenges, there is a pressing need to explore novel diagnostic targets. Thus, this study aimed to evaluate the diagnostic potential of long non-coding RNAs (lncRNAs) for AS. Methods: The search encompassed various databases including PubMed, Scopus, Embase, and Hinari. Analysis of pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) was carried out using Stata 17.0 software, employing a random effects model. Heterogeneity among studies was assessed through the Cochran-Q test and I2 statistic tests, followed by subgroup analyses to delve into primary sources of heterogeneity. Publication bias was assessed using Deeks’ funnel plot, while Fagan’s nomogram was used to evaluate the clinical utility of lncRNAs for AS. Furthermore, a sensitivity analysis was conducted to assess the robustness and reliability of the findings. Results: This systematic review and meta-analysis synthesized data from 11 articles, of which 6 were included in the meta-analysis. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC of lncRNAs for diagnosing AS were calculated as 0.81 (95% CI, 0.73–0.88), 0.81 (95% CI, 0.55–0.93), 4.2 (95% CI, 1.64–10.77), 0.23 (95% CI, 0.17–0.32), 18.1 (95% CI, 6.39–51.24), and 0.86 (95% CI, 0.83–0.89), respectively. Furthermore, subgroup analysis revealed that lncRNAs identified in peripheral blood mononuclear cells (PMBCs), those showing upregulation, studies utilizing β-actin as the internal reference control, and research involving AS patients from China demonstrated enhanced diagnostic accuracy for AS. Conclusions: In conclusion, the existing evidence indicates that lncRNAs have substantial diagnostic value in predicting AS and can serve as effective non-invasive markers for the condition. However, the results should undergo further validation through well-designed longitudinal studies with larger sample sizes in the future to enhance their reliability and generalizability.