Emerging insights into MicroRNA therapeutics and diagnostics for atherosclerotic cardiovascular disease: A narrative...

Atherosclerosis remains a leading cause of cardiovascular morbidity and mortality, highlighting the need for novel therapeutic strategies. MicroRNAs (miRs), small noncoding RNAs, play crucial regulatory roles in the pathogenesis of atherosclerotic cardiovascular disease (ASCVD). This review explores recent advances in understanding the functions of miRs in atherosclerosis, focusing on their potential as diagnostic biomarkers and therapeutic targets.

A literature review was conducted to assess the involvement of miRs in key atherosclerotic processes, including lipid metabolism, endothelial dysfunction, inflammation, vascular smooth muscle cell (VSMC) proliferation, and plaque stability. The study also evaluated the potential of circulating miRs as biomarkers and their therapeutic applications.

Numerous miRs have been identified as key modulators of atherosclerosis, influencing disease progression through various molecular pathways. Circulating miRs show promise as minimally invasive biomarkers for early diagnosis and risk stratification. Preclinical studies using miR mimics and inhibitors have demonstrated potential benefits, including reduced lesion formation, improved plaque stability, and enhanced vascular function. However, challenges such as targeted delivery, off-target effects, and specificity remain significant barriers to clinical translation. Emerging technologies like single-cell RNA sequencing and spatial transcriptomics are offering deeper insights into miR-mediated regulation within atherosclerotic plaques. In parallel, advances in nanoparticle and targeted delivery systems are helping to improve the safety and efficacy of miR-based therapies.

miRs hold significant promise as diagnostic and therapeutic tools in ASCVD. Future research should prioritize robust, well-designed studies and standardized evaluation criteria to facilitate the development of miR-based precision medicine in atherosclerosis.