Nanomedicine-driven microRNA therapy: a precision approach for eosinophilic granulomatosis with polyangiitis

Eosinophilic granulomatosis with polyangiitis (EGPA), the rarest form of ANCA-associated vasculitis, remains a challenging condition to manage due to its complex pathophysiology involving eosinophilia, granulomatous inflammation, and small- to medium-vessel necrotizing vasculitis. Emerging evidence suggests that microRNAs (miRNAs), which show distinct patterns of upregulation and downregulation in EGPA patients, play a critical role in disease activity and progression. Advances in nanomedicine have enabled targeted delivery of RNA-based therapies, including antisense oligonucleotides, small interfering RNAs, and therapeutic miRNAs, directly to immune and endothelial cells. Recent findings, such as the identification of LINC02193 as a microRNA sponge correlated with disease activity, highlight their diagnostic and therapeutic promise. While miRNA-based nanotherapies represent a precision approach capable of modulating disease-specific pathways with fewer side effects, their clinical translation requires further research to validate safety, efficacy, and long-term outcomes.