MicroRNA-126 as an endogenous molecule for hypoxic/ischemic tolerance in neuroprotection

Hypoxic and ischaemic brain injuries are notable contributors to neurological disability and mortality, posing major global public health challenges. Notably, microRNA-126 (miR-126) has emerged as a key regulator in the complex pathophysiology of stroke. Hypoxic/ischaemic (HI) preconditioning upregulates miR-126, offering protection against HI brain injury. This article reviews the advances in understanding the molecular regulation of miR-126, focusing on epigenetic modifications, transcription factors, and hypoxia. miR-126 is crucial for modulating inflammation, promoting angiogenesis and neurogenesis, and supporting post-stroke recovery. Additionally, we highlight the therapeutic potential of exosomal miR-126 in treating HI brain injury.