MicroRNAs and HPV oncogenes crosstalk, their biomarker potential and therapeutic utility in cervical cancer

Cervical cancer remains a significant global health challenge, particularly in low-income regions, where incidence and fatality rates exceed WHO eradication limits. The miRNAs are emerging as crucial molecular markers in disease diagnostics and therapeutics. Their expression is influenced by Human Papillomavirus (HPV) infection leading to genomic instability and cervical carcinogenesis. The miRNA-based biomarkers exhibit potential for noninvasive identification in serum, urine, cervical mucus, exosomes, and tissue samples, and they also contribute to chemosensitization and resistance mechanisms. However, their clinical translation is hindered by multiple challenges. This review explores the mechanistic roles of miRNAs in HPV-mediated cervical cancer progression, their implications in diagnosis and therapy, and the barriers limiting their clinical application. Additionally, it outlines strategies to overcome translational hurdles, including combinatorial delivery, structural modifications, nanovehicles based delivery, viral vector systems, paving the way for miRNA-based interventions in cervical cancer management.