The crosstalk between MiRNAs and autophagy in leukemia: mechanisms and therapeutic insights

Autophagy, a process of cellular degradation and recycling, plays a biphasic role in leukemia; it acts either as a protective process that promotes the cancer cell to survive, or as a pathway that triggers cell death depending on certain conditions. MicroRNAs (miRNAs) regulate many important genes of autophagy, and these involve autophagy's role in leukemia progression, drug resistance and therapy response. In this review, we will lay out the framework of how autophagy and miRNAs interact in that context and concentrate upon studies representative of how certain miRNAs such as miR-21, miR-155, or miR-29, regulate autophagy signaling pathways. We will also reflect on the potential of targeting the autophagy-miRNA axis to overcome drug resistance and enhance the outcome with treatment of leukemia. Although the utilization of miRNA-therapy and inhibitors have shown preclinical viability in leukemia, issues of delivery, specificity and toxicity create many obstacles. A greater comprehension of the molecular mechanisms underlying miRNA-mediated regulation of autophagy could lead to effective and novel therapeutic strategies for leukemia. This review highlights a clinical rationale to employ miRNAs and target autophagy modulation as a possible strategy to combat drug resistance leukemia.