Leveraging circulating microRNAs for personalized disease-modifying therapies in type 1 diabetes

Type 1 Diabetes (T1D) is a chronic autoimmune disease marked by the progressive immune-mediated destruction of insulin-producing pancreatic beta-cells. The clinical management of T1D is complicated by its heterogeneity and the variability in individual responses to treatment. Personalized medicine has emerged as a promising strategy to address these challenges by tailoring interventions to individual patient profiles. Circulating microRNAs (miRNAs) - small, non-coding RNAs found in bodily fluids - represent potential biomarkers across various diseases, including T1D. This review examines the role of circulating miRNAs in advancing personalized medicine for T1D, emphasizing on their application in the response prediction of innovative therapeutic strategies. We discuss key miRNAs -detectable in blood plasma- implicated in modulating immune responses and beta-cell function and associated with patient-specific differences in disease onset, progression, and therapeutic responses, underscoring their potential in refining treatment strategies. We explore how miRNA signatures can enhance clinical decision-making by predicting disease progression, assessing susceptibility to complications, and monitoring responses to newly proposed therapies, thus leveraging these more precise and individualized treatment regimens, improving the effectiveness and outcomes of T1D management. The integration of circulating miRNAs into personalized treatment frameworks represents a transformative opportunity to advance T1D care and improve patients' outcomes.