Non coding RNA biomarkers in pemphigus disease.

Pemphigus represents a group of potentially life-threatening autoimmune blistering diseases characterized by the production of pathogenic autoantibodies against desmosomal cadherins, leading to loss of cell adhesion. Early and accurate diagnosis remains critical for optimal management, yet current diagnostic approaches largely rely on invasive biopsies and serological assays that do not always predict disease progression or therapeutic response. In this context, the identification of reliable biomarkers is essential to enhance diagnostic precision, monitor disease activity, and guide treatment strategies. Non-coding RNAs (ncRNAs), particularly microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), have emerged as promising biomarker candidates due to their stability in body fluids, tissue- and disease-specific expression patterns, and regulatory functions in immune processes. Increasing evidence suggests that dysregulated ncRNAs play significant roles in the immunopathogenesis of pemphigus, influencing cytokine signaling, immune cell differentiation, and keratinocyte adhesion. Therefore, herein, we summarize current findings on the involvement of specific miRNAs and lncRNAs in pemphigus pathogenesis, their diagnostic and prognostic potential, and the emerging therapeutic opportunities based on modulating ncRNA expression. Additionally, we address the limitations and challenges associated with clinical translation of ncRNA research and highlight future directions that may facilitate the incorporation of ncRNAs into personalized medicine approaches for pemphigus patients.