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The Role of MicroRNAs in the Progression of Metabolic Dysfunction-associated Steatotic Liver Disease

Year: 2026
Type: article
Abstract: Metabolic dysfunction-associated steatotic liver disease (MASLD) is a common chronic liver disease that can progress from simple steatosis to metabolic dysfunction-associated steatohepatitis (MASH), advanced fibrosis or cirrhosis, and hepatocellular carcinoma.MicroRNAs (miRNAs) are increasingly recognized as central post-transcriptional regulators of lipid metabolism, insulin resistance, inflammatory signaling, fibrogenesis, and exosome-mediated intercellular communication.This review critically reassesses key miRNA axes implicated in MASLD progression, focusing on mechanistically supported examples (miR-34a, miR-21, miR-122, the miR-29 family, miR-20b, and miR-93), tissue miRNA isoforms (isomiRs), circulating miRNA biomarkers, and therapeutic translation.Recent studies support the diagnostic relevance of selected circulating miRNA panels and hepatic isomiR landscapes; however, current evidence remains insufficient to position miRNAs as standalone replacements for established noninvasive tests or liver biopsy.Liver-directed oligonucleotide delivery platforms continue to advance; however, MASLD-specific miRNA drug development remains largely preclinical, with only limited exploratory early clinical activity.Importantly, the rapidly evolving therapeutic landscape, which currently includes Food and Drug Administration-approved therapies, some of which have been granted accelerated approval, for adults with noncirrhotic steatohepatitis/ MASH and F2-F3 fibrosis, reshapes how miRNA therapeutics should be positioned: not as broad substitutes, but as mechanism-informed, patient-stratified, and potentially combinationbased approaches.Overall, miRNA and isomiR biology provide a compelling framework for precision diagnostics and next-generation therapeutic design in MASLD, provided that mechanistic rigor, preanalytical standardization, and clinically meaningful endpoints are maintained.
Language: English
Subfield: Cancer Research
Open Access status: hybrid
OpenAlex ID: W7154993535
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