Investigating the Regulatory Mechanisms and Prognostic Significance of miR-941 Targeting the Nrf2/Keap1 Pathway in Elderly Ischemic Stroke Patients.

This study aims to explore the role and underlying correlation of miR-941 in the targeted regulation of the Keap1/Nrf2 signaling pathway in the prognosis of senile ischemic stroke (IS), providing new targets and strategies for clinical treatment. Totally 102 elderly IS patients admitted from July 2022 to June 2023 in Jing'an District Shibei hospital were enrolled and divided into hyperacute, acute, subacute, and chronic phases by disease course and imaging results. Peripheral blood samples were collected. RT-PCR was used to detect miR-941, Nrf2 mRNA and Keap1 mRNA expression levels, and ELISA for HO-1, NQO-1, SOD, and GSH-Px1 expression. The modified Rankin scale (mRS) evaluated patients' prognosis, and logistic regression analyzed influencing factors. The receiver operating characteristic (ROC) and Kaplan-Meier curves analyzed the predictive value of miR-941 and the Nrf2/Keap1 signaling pathway in IS prognosis and their correlation with patients' survival periods. The expression levels of miR-941 and Nrf2 mRNA gradually decreased in different stages of IS, while the expression of Keap1 mRNA gradually increased, and the expression levels of antioxidant factors HO-1, NQO-1, SOD, and GSH-Px1 also decreased significantly (all P < 0.001). The relative abundances of miR-941 and Nrf2 mRNA were significantly negatively correlated with the NIHSS score (P < 0.001), while Keap1 mRNA was positively correlated with the NIHSS score (P < 0.001). Logistic regression analysis showed that miR-941 and Nrf2 mRNA were protective factors for a good prognosis of IS (P < 0.001), while Keap1 mRNA was a risk factor for a poor prognosis (P < 0.01). ROC curve analysis showed that miR-941 had high predictive efficacy in the prognosis of IS (the AUCs were 0.801). Kaplan-Meier survival analysis showed that the survival periods of patients in the high-expression groups of miR-941 and Nrf2 were significantly longer than those in the low-expression groups (P < 0.001), while the survival period of patients in the high-expression group of Keap1 mRNA was significantly shortened (P < 0.001). The correlation between miR-941 and Keap1/Nrf2 signaling pathway is crucial in the course and prognosis of senile ischemic cerebral infarction. High miR-941 and Nrf2 mRNA levels correlate with good prognosis, while high Keap1 mRNA levels link to poor prognosis. These molecules probably serve as potential biomarkers for clinical prognosis and new treatment targets.