Circular RNA expression profiles in the development of acute chronic liver failure in hepatitis B virus-infected patients

Background: Hundreds of millions of people worldwide suffer from chronic hepatitis B (CHB), which is thus among the most serious public health problems. CHB can lead to serious acute chronic liver failure (ACLF). Since ACLF has a very high mortality rate, prediction of ACLF risk is a critical issue in clinical practice. Methods: : To investigate the development of ACLF from CHB, circular RNA (circRNA), a novel type of endogenous non-coding RNA, was examined in healthy control (HC) subjects and CHB and ACLF patients using high-throughput RNA sequencing technology. Differentially expressed circRNAs were selected and analyzed by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) biological pathway analyses, circRNA-miRNA co-expression networks, and statistical analyses. Results: : A total of 21,101 circRNAs were identified in HC, CHB and ACLF subjects. Compared with the HCs, 4 up-regulated and 14 down-regulated circRNAs were identified in ACLF subjects, which exhibited a consistent trend of change in the three groups. GO analysis revealed that regulation of lymphocyte activation and macrophage tolerance induction were the most important biological processes in ACLF progression. KEGG pathway analysis revealed that primary immunodeficiency and NOD-like receptor signaling pathways were the most enriched terms. The circRNA-miRNA co-expression network and statistical analyses showed that circRNA_07734, circRNA_08533, and circRNA_16083 were the most important circRNAs in the process of ACLF. Conclusions: : Immune dysfunction and immunodeficiency may be critical in the development of ACLF, which results in aberrant expression of circRNAs, especially circRNA_07734, circRNA_08533, and circRNA_16083.