A Systematic Review of miRNA and cfDNA as Potential Biomarkers for Liquid Biopsy in Myocarditis and Inflammatory Dilated Cardiomyopathy

Round 1

Reviewer 1 Report

This study summarizes and evaluates the validity of microRNAs as biomarkers of myocardial inflammation. A systematic review of liquid biopsy markers as potential candidates for the detection of inflammatory myocardial disease, and finally identified three microRNAs (1) miR-Chr8:96, (2) miR-155 and (3) miR-206 as the best candidates for potential LB markers of myocardial inflammatory state. This provides a new strategy and means for the diagnosis of myocarditis.

Here, one point needs to be explained by the author. What was the basis and criteria for the authors to extract data and use an internally created scale to screen and assess miRNAs?

Author Response

Dear Reviewer,

Thank you very much for this comment. Our literature search showed that the studies involving the use of miRNA in cardiac diseases are very heterogenous – many miRNAs are being studies and many different results are obtained. Because of that, classical reviews are highly susceptible to bias. We decided to try implementing a systematic approach to “tidy” these results. As we started creating search key and extracting eligible papers, we noticed that it would be very hard / impossible to compare them using numerical methods (metanalysis).  We had to develop our own approach to choose the most suitable miRNA for liquid biopsy in inflammatory cardiac diseases. The criteria were set up based on our consensus and are based on: (1) positive selection of candidates, and (2) rejection of miRNAs that did not fulfill our requirements. We believe that this approach is good, but there might be better solution. It is a first paper that applied this strategy, and it would be a great pleasure for us, if it inspires others to do it better.

Reviewer 2 Report

Comments for author File: Comments.pdf

Author Response

Please see the attachment.

Author Response File: Author Response.pdf