Work

MicroRNA dysregulation in pemphigus: a systematic review of expression profiles and molecular targets

Year: 2026

Type: review

Abstract: Pemphigus is a severe autoimmune bullous disease characterized by the production of pathogenic autoantibodies leading to acantholysis. Emerging evidence suggests that microRNA regulate immune responses and may contribute to disease pathogenesis. However, an updated, integrative synthesis linking miRNA expression profiles to their molecular targets remains lacking. This review specifically addresses the expression profiles, target genes, and molecular pathways of miR-338-3p, miR-146a-5p, miR-155-5p and miR-424-5p, and their potential involvement in pemphigus. Original studies investigating microRNA expression or functional roles in patients with pemphigus or relevant experimental models were considered eligible. A literature search was conducted in Scopus, PubMed and ScienceDirect scientific databases between January 2000 and September 2025. Titles, abstracts, and full texts were screened, by two independent researchers according to predefined eligibility criteria. A total of nine studies were included in this review. Clinical evidence establishes miR-338-3p, miR-155-5p, and miR-424-5p as robust diagnostic biomarkers of active disease, with AUC values reaching 0.988. Notably, miR-338-3p and miR-155-5p levels show significant positive correlations with PDAI scores. Mechanistically, for miR-338-3p, the genes RNF114, TRADD, and RUNX1 have been experimentally validated as direct targets, linking this miRNA to Th1/Th2 imbalance and the suppression of FOXP3-mediated Treg activity. Similarly, miR-146a-5p has been validated to target the NF-κB adaptors TRAF6 and IRAK1, acting as an endogenous anti-inflammatory regulator. These findings identify specific miRNA axes as potential therapeutic targets and high-precision tools for clinical stratification and disease severity. However, further large-scale and mechanistic studies are needed to validate their functional target genes and clinical utility.

Source: Frontiers in Immunology

DOI: 10.3389/fimmu.2026.1871963