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MicroRNA Expression and Carotid Plaque Vulnerability: An Exploratory Tissue-Based Study.

Lucia Scurto^1,2, Ottavia Borghese^1,2, Giovanni Tinelli^1,2

¹Unit of Vascular Surgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.

Journal of Personalized Medicine

|May 26, 2026

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Researchers explored microRNAs (miRNAs) in carotid plaques, finding miR-122 and miR-197 may indicate instability. Further validation is needed for these potential biomarkers of atherosclerotic plaque vulnerability.

Area of Science:

Biochemistry
Molecular Biology
Cardiovascular Research

Background:

Carotid plaque instability identification is challenging for preoperative risk assessment.
Duplex ultrasound detects stenosis but not consistently plaque behavior.
MicroRNAs (miRNAs) are implicated in atherosclerosis and plaque destabilization.

Purpose of the Study:

To investigate tissue-level miRNA expression in carotid plaques.
To correlate miRNA expression with histological plaque vulnerability.
To generate hypotheses for future biomarker development.

Main Methods:

Pilot study on patients undergoing carotid endarterectomy for high-grade stenosis.
Multiparametric plaque vulnerability assessment (ultrasound, macroscopic, histology).

Keywords:

atherosclerotic plaque biomarkers carotid miRNA stroke vulnerable plaque

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miRNA profiling (qRT-PCR) of 47 candidate miRNAs in selected plaques.

Main Results:

Five plaques (3 unstable, 2 stable) met strict vulnerability criteria.
miR-122 and miR-197 showed a trend toward higher expression in unstable plaques.
Unstable plaques exhibited histological features like lipid-rich necrotic cores.

Conclusions:

miR-122 and miR-197 warrant further investigation as potential instability biomarkers.
Findings are preliminary due to small sample size; hypothesis-generating only.
Larger cohorts and circulating miRNA evaluation are needed for validation and clinical application.