Wang GL, Li Q, Ni JQ, Shen YF, Xu L, Jin Q. Association of peripheral blood-derived mesenchymal stem cells exosomal circular RNAs with diagnosis and inflammatory response in acute mesenteric ischemia. World J Stem Cells 2026; 18(4): 117067 [DOI: 10.4252/wjsc.v18.i4.117067]
Corresponding Author of This Article
Qin Jin, Chief Physician, Department of Vascular Surgery, The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Jiaxing 314001, Zhejiang Province, China. chinekim@163.com
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Apr 26, 2026 (publication date) through Apr 22, 2026
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World Journal of Stem Cells
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Wang GL, Li Q, Ni JQ, Shen YF, Xu L, Jin Q. Association of peripheral blood-derived mesenchymal stem cells exosomal circular RNAs with diagnosis and inflammatory response in acute mesenteric ischemia. World J Stem Cells 2026; 18(4): 117067 [DOI: 10.4252/wjsc.v18.i4.117067]
World J Stem Cells. Apr 26, 2026; 18(4): 117067 Published online Apr 26, 2026. doi: 10.4252/wjsc.v18.i4.117067
Association of peripheral blood-derived mesenchymal stem cells exosomal circular RNAs with diagnosis and inflammatory response in acute mesenteric ischemia
Guo-Liang Wang, Qing Li, Jian-Qi Ni, Yi-Feng Shen, Liu Xu, Qin Jin
Guo-Liang Wang, Jian-Qi Ni, Yi-Feng Shen, Liu Xu, Qin Jin, Department of Vascular Surgery, The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, Jiaxing 314001, Zhejiang Province, China
Qing Li, Department of Pulmonary and Critical Care Medicine, Xianning Central Hospital, First Affiliated Hospital of Hubei University of Science and Technology, Xianning 437000, Hubei Province, China
Author contributions: Wang GL conducted the majority of experiments and wrote the manuscript; Li Q designed the study and served as a scientific advisor and guarantor; Ni JQ corrected the manuscript; Shen YF was involved in applying the analytical tools; Xu L and Jin Q participated in the collection of human material.
Supported by the Joint Development of Disciplines by Jiaxing City and Provincial Government; and the National Key Clinical Specialty Construction Project, No. 2023-GJZK-001.
Institutional review board statement: This study was approved by First Hospital of Jiaxing (Approval No. 2024-LP-159), and the study followed the ethical guidelines of the Declaration of Helsinki.
Informed consent statement: Informed consent was obtained from all study participants.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: No additional data are available.
Corresponding author: Qin Jin, Chief Physician, Department of Vascular Surgery, The First Hospital of Jiaxing, Affiliated Hospital of Jiaxing University, No. 1882 Zhonghuan South Road, Jiaxing 314001, Zhejiang Province, China. chinekim@163.com
Received: December 5, 2025 Revised: January 4, 2026 Accepted: February 9, 2026 Published online: April 26, 2026 Processing time: 136 Days and 0.1 Hours
Abstract
BACKGROUND
Acute mesenteric ischemia (AMI) is associated with high mortality owing to delayed diagnosis and the absence of biomarkers capable of distinguishing disease subtypes or inflammatory burden. Mesenchymal stem cells (MSCs) exosomal circular RNAs (circRNAs) show diagnostic potential in other diseases.
AIM
To evaluate the utility of MSCs exosomal circRNAs in AMI, particularly for early detection and subtyping.
METHODS
Peripheral blood-derived MSCs (PBMSCs) from 80 patients with AMI (stratified by etiology: 48 arterial AMI, 32 venous AMI, 36 early reversible, 44 late necrotic) and 125 controls were obtained at initial hospital admission. Exosomal circRNAs were isolated via ultracentrifugation, validated by transmission electron microscopy and nanoparticle tracking analysis, and quantified by quantitative real-time polymerase chain reaction. Plasma intestinal fatty acid binding protein (IFABP), d-lactate, interleukin-6 (IL-6), tumor necrosis factor-α, IFABP, D-lactate, IL-6, and neutrophil-to-lymphocyte ratio were measured. Pearson’s test was used to assess the diagnostic performance of receiver operating characteristic analysis.
RESULTS
Patients with AMI exhibited significantly elevated PBMSCs exosomal circ-Eya3 (P < 0.001) and reduced circEZH2_005 levels (P < 0.001). Circ-Eya3 correlated positively with IFABP (r = 0.606), D-lactate (r = 0.384), IL-6 (r = 0.551), and neutrophil-to-lymphocyte ratio (r = 0.601) (all P < 0.001), whereas circEZH2_005 showed inverse correlations (r = -0.580 to -0.403; P < 0.001). Critically, circEZH2_005 expression was lower in arterial AMI than in venous AMI (P = 0.003). The combination of circ-Eya3, circEZH2_005, and D-lactate achieved excellent diagnostic accuracy (area under the curve = 0.891). Post-reperfusion, circ-Eya3 increased (P < 0.05), while circEZH2_005 decreased (P < 0.05).
CONCLUSION
PBMSCs exosomal circ-Eya3 and circEZH2_005 serve as novel biomarkers for AMI, reflecting intestinal injury severity, systemic inflammation, and disease subtype. Their integration with D-lactate enables high-accuracy diagnosis, whereas differential expression across arterial/venous AMI and ischemia stages offers clinical utility for guiding intervention strategies.
Core Tip: Peripheral blood-derived mesenchymal stem cells exosomal circ-Eya3 and circEZH2_005 serve as novel biomarkers for acute mesenteric ischemia (AMI), reflecting intestinal injury severity, systemic inflammation, and disease subtype. Their integration with D-lactate enables high-accuracy diagnosis, whereas differential expression across arterial/venous AMI and ischemia stages offers clinical utility for guiding intervention strategies. Peripheral blood-derived mesenchymal stem cells exosomal circ-Eya3 and circEZH2_005 are promising biomarkers for the early diagnosis, subtyping, staging, and post-reperfusion monitoring of AMI.
