The Role of MicroRNAs in the Progression of Metabolic Dysfunction-associated Steatotic Liver Disease
10.52927/jdcr.2026.14.1.82
- Author:
Jang Hyun CHOI
1
Author Information
1. Department of Biological Sciences, Ulsan National Institute of Science and Technology (UNIST), Ulsan, Korea
- Publication Type:SPECIAL ISSUE (REVIEW ARTICLE)
- From:
Journal of Digestive Cancer Research
2026;14(1):82-92
- CountryRepublic of Korea
- Language:English
-
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.
