Khan Atta Ullah, Chacon-Millan Pilar, Stiuso Paola
Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Napoli, Italy.
Int J Mol Sci. 2025 Jul 16;26(14):6822. doi: 10.3390/ijms26146822.
Ulcerative colitis (UC) is a chronic inflammatory disease that affects the colon, triggering persistent inflammation and ulceration, resulting in a severe impact on patients' quality of life. Currently, the standard diagnostic methods for UC include invasive procedures such as colonoscopy and the use of non-specific inflammatory markers like C-reactive protein, which can be inconvenient or painful and lack specificity. This underscores the need for non-invasive and highly specific biomarkers for UC. MicroRNAs (miRNAs) are small non-coding RNAs, typically 22 nucleotides in length, which are well described as gene expression regulators. Several studies have reported their differential expression in various pathological conditions, including UC. Due to their role in gene regulation and stability in biological fluids, miRNAs present a promising opportunity as biomarkers. This systematic review explores the potential use of miRNAs as diagnostic biomarkers to distinguish between active and inactive ulcerative colitis. Following PRISMA guidelines and based on inclusion and exclusion criteria, seven studies, encompassing a total of 514 participants (181 with active UC and 116 with inactive UC), were included. Multiple miRNAs exhibiting differential expression between active and inactive UC were identified. Most notably, miR-21, miR-126, miR-146b-5p, and miR-223 exhibited consistent upregulation in active UC, suggesting their potential as diagnostic biomarkers. Supporting these findings is the fact that these miRNAs are involved in inflammatory pathways, further highlighting their relevance to the pathogenesis of UC. This review emphasizes the need for further validation studies with larger cohorts to confirm the utility of miRNAs as diagnostic tools for UC disease activity differentiation, which could enhance non-invasive disease monitoring and inform therapeutic decision-making. Future research should also evaluate the prognostic potential of these miRNAs for predicting treatment responses and long-term disease outcomes.
溃疡性结肠炎（UC）是一种影响结肠的慢性炎症性疾病，引发持续的炎症和溃疡，对患者的生活质量造成严重影响。目前，UC的标准诊断方法包括侵入性检查，如结肠镜检查，以及使用非特异性炎症标志物，如C反应蛋白，这些方法可能不便或痛苦，且缺乏特异性。这凸显了对UC的非侵入性和高特异性生物标志物的需求。微小RNA（miRNA）是小的非编码RNA，通常长度为22个核苷酸，被广泛描述为基因表达调节因子。多项研究报告了它们在包括UC在内的各种病理状况下的差异表达。由于其在基因调控中的作用以及在生物体液中的稳定性，miRNA作为生物标志物具有广阔前景。本系统评价探讨了miRNA作为诊断生物标志物以区分活动期和非活动期溃疡性结肠炎的潜在用途。遵循PRISMA指南并根据纳入和排除标准，纳入了7项研究，共514名参与者（181名活动期UC患者和116名非活动期UC患者）。鉴定出了在活动期和非活动期UC之间表现出差异表达的多种miRNA。最值得注意的是，miR-21、miR-126、miR-146b-5p和miR-223在活动期UC中表现出一致的上调，表明它们作为诊断生物标志物的潜力。支持这些发现的是，这些miRNA参与炎症途径，进一步突出了它们与UC发病机制的相关性。本综述强调需要进行更大样本量的进一步验证研究，以确认miRNA作为UC疾病活动度区分诊断工具的效用，这可以加强非侵入性疾病监测并为治疗决策提供依据。未来的研究还应评估这些miRNA预测治疗反应和长期疾病结局的预后潜力。
