Research progress on the mechanism, diagnosis, and treatment of exosomal miRNA in chronic prostatitis

Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition that significantly impairs men's quality of life. Its pathogenesis remains incompletely understood, and there is a lack of specific diagnostic methods. As important signaling molecules in intercellular communication, microRNAs (miRNAs) in exosomes play a key role in the pathological progression of CP/CPPS. This review proposes that 'exosome miRNA-mediated interactions within the local urogenital microenvironment' constitute the core mechanism driving the chronicity and localization of CP/CPPS. We provide a comprehensive overview of the diagnostic and prognostic value of specific exosome miRNA expression profiles detected in the biofluids (such as prostatic fluid and urine) of CP/CPPS patients. Furthermore, we explore the dual role that exosomal miRNAs play in disease initiation and progression by regulating inflammation, oxidative stress, and immune responses. Finally, we discuss the potential of exosome-based miRNA delivery systems as novel targeted therapeutic strategies for CP/CPPS. In summary, exosomal miRNAs are of great significance for understanding the complex pathological networks underlying CP/CPPS. Future research should focus on the validation of specific biomarkers, the elucidation of intercellular communication networks, and the advancement of their clinical translation and application.