The emerging molecular landscape of abdominal aortic aneurysms: non-coding RNAs as diagnostic and therapeutic targets

An abdominal aortic aneurysm (AAA) is a progressive, often asymptomatic condition whose rupture is associated with a high mortality rate. Ultrasonography and computed tomography are established diagnostic methods, while molecular biomarkers may provide additional information about disease activity. This review discusses the potential role of non-coding RNAs (ncRNAs) as diagnostic and therapeutic tools in AAAs. These molecules, including microRNAs (miRNAs), long non-coding RNAs (lncRNAs) and circular RNAs (circRNAs), are strongly involved in the regulation of gene expression. Through binding to their target mRNAs, miRNAs primarily suppress translation or promote mRNA degradation. Some lncRNAs and circRNAs act as miRNA sponges, affecting their availability. Here, these mechanisms are discussed by pathological function, distinguishing human tissue and circulating studies from animal, cellular and computational findings. Particular attention is given to miR-21, H19, GAS5, circCdyl and miR-26b-3p, which have functional experimental evidence or human biomarker data beyond expression profiling. Abnormal expression can be detected in peripheral blood or aortic tissue, but these findings do not necessarily predict aneurysm growth or rupture. Integration of ncRNA profiling with imaging and clinical parameters may improve the assessment of AAAs. However, prospective validation and further studies of delivery and safety are needed before these molecules can be used in clinical practice.