Exosomal miRNA as an early diagnostic biomarker and potential therapeutic target for cerebral small vessel disease

Liu Yuxuan; Guan Dongsheng; Wang Jing; Ren Yihan

doi:10.12307/2026.144

Abstract：BACKGROUND:In recent years,microRNA(miRNA)has received extensive attention in the pathogenesis and diagnosis and treatment of cerebral small vessel disease,and is involved in the regulation of various pathological processes of cerebral small vessel disease. OBJECTIVE:To review the role of miRNA in the pathogenesis,diagnosis,and treatment of cerebral small vessel disease,and to provide effective therapeutic targets and new potential biomarkers for the early diagnosis of cerebral small vessel disease. METHODS:"microRNA,cerebral small vessel disease,blood-brain barrier,chronic cerebral hypoperfusion,inflammation,apoptosis,diagnosis,biomarkers"were used as English search terms for PubMed search."Exosomal miRNA,cerebral small vessel disease"were used as Chinese search terms for CNKI search.The search time limit was from inception to January 2025.Through the preliminary screening of reading titles and abstracts,the literature with poor relevance and duplicate content was excluded,and finally 72 articles were included for inductive discussion. RESULTS AND CONCLUSION:(1)Through the excavation and discussion of the biological functions and characteristics of exosomal miRNAs,it was confirmed that exosomal miRNAs are important related components in the occurrence and progression of cerebral small vessel disease diseases.(2)Exosomal miRNA participates in the regulation of various pathological processes of cerebral small vessel disease,and plays an important role in the pathological mechanism of cerebral small vessel disease by protecting the blood-brain barrier,improving chronic cerebral hypoperfusion,reducing inflammatory response,and inhibiting apoptosis.(3)Exosomal miRNA can effectively target different pathological links of cerebral small vessel disease by targeting multiple signaling pathways to intervene at different stages of pathological development.(4)The combination of multiple exosomal miRNAs can effectively improve the disease process of cerebral small vessel disease,and the regulatory effects of different miRNAs play different roles in each stage of the pathological mechanism,and the construction of miRNA action network is of great significance for regulating the development of cerebral small vessel disease.(5)Exosomal miRNAs are widely and stably present in various body fluids,and their specific and significant expression in urine,serum,blood and other body fluids of cerebral small vessel disease patients can be used as an effective basis for the diagnosis of cerebral small vessel disease patients.(6)At present,the main clinical treatment method is to inject miRNA mimics or antagonists to regulate the expression of downstream target genes,and how to exert the most effective therapeutic effect of miRNA still needs to be further studied.(7)As exosome contents,miRNA has great application prospects in the treatment of cerebral small vessel disease.In the future,its mechanism of action should be further explored to provide effective ideas and further optimize the clinical treatment of cerebral small vessel disease.