# PCR-based miRNA assessment of neonatal opioid withdrawal syndrome (NOWS) severity

> **NIH NIH R44** · FYR DIAGNOSTICS, INC. · 2021 · $351,120

## Abstract

Abstract
Opioid use disorder (OUD) has become a national crisis, affecting over 2 million Americans. The number of
pregnant women with OUD in the U.S. increased almost 5-fold in the past decade, leading to a similar surge in
infants born with neonatal opioid withdrawal syndrome (NOWS), from 1.5 to 8 per 1,000 hospital births (32,000
cases total) between 2004 and 2014. Associated hospital costs have risen by 35%, reaching $532 million in
2014 ($462 million of which was financed by Medicaid). Among neonates prenatally exposed to illicit opioids,
55-94% develop withdrawal symptoms, including respiratory, gastrointestinal, and feeding problems. Infants with
severe NOWS often require prolonged hospitalization, and 2-11% develop serious complications, such as
seizures and weight loss. Severe cases often require pharmacological intervention to mitigate negative long-
term impacts on the infant's neurological development. Per national guidelines, infants born to opioid users are
monitored (72-96 hours) in the hospital for signs of NOWS. However, different scales are currently in use to
monitor the severity of symptoms, leading to inconsistencies in diagnosis. Moreover, NOWS can present
anywhere from birth to 7 days after, sometimes leading to costly readmissions after release. When
pharmacologic measures are needed, these delays can lead to an increased risk of infant morbidity. Therefore,
there is an urgent need for an accessible, inexpensive, sensitive, and accurate diagnostic tool to support optimal
clinical outcomes of infants with NOWS. To meet this need, FYR Diagnostics, alongside the University of
New Mexico (UNM) and Texas A&M University (TAMU), will develop a convenient, non-invasive
diagnostic assay from umbilical cord samples for early detection of severe NOWS to improve
identification of high- and low-risk infants. The assay will be based on two innovations: a) an miRNA
signature that identifies infants with severe NOWS; and b) a proprietary patent-pending ultrasensitive DNA
Amplification Reaction (UDAR) chemistry that uses a simple primer design to rapidly and directly detect individual
miRNAs at low concentrations currently below the limit of detection. In Phase I, FYR will demonstrate the
feasibility of this novel quantitative tool by 1) testing the proprietary UDAR chemistry on predictive miRNA
biomarkers using umbilical cord plasma samples previously used by UNM/TAMU; and 2) comparing the UDAR-
based assay to traditional RT-qPCR-based assays for detection of NOWS miRNA biomarkers to validate assay
performance and demonstrate that the UDAR-based assay exhibits equivalent or superior specificity and
sensitivity. In Phase II, FYR, UNM, and TAMU will conduct a large-scale clinical study to validate the NOWS
early detection tool. The clinical validation study (N=150) will evaluate the analytical and clinical feasibility of the
UDAR-based assay, demonstrating that it exhibits comparable performance and predictive utility of NOWS
severity acros...

## Key facts

- **NIH application ID:** 10259411
- **Project number:** 1R44DA054017-01
- **Recipient organization:** FYR DIAGNOSTICS, INC.
- **Principal Investigator:** SARJUBHAI Amratbhai PATEL
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $351,120
- **Award type:** 1
- **Project period:** 2021-08-15 → 2023-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10259411

## Citation

> US National Institutes of Health, RePORTER application 10259411, PCR-based miRNA assessment of neonatal opioid withdrawal syndrome (NOWS) severity (1R44DA054017-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10259411. Licensed CC0.

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