간질환 정밀의료에서 MicroRNA의 역할

초록

Chronic liver diseases, including metabolic dysfunction-associated steatotic liver disease, alcohol-associated liver disease, and hepatocellular carcinoma (HCC), account for approximatelytwo million deaths globally each year. Despite increasing insight into their pathophysiology,substantial heterogeneity in disease progression, and therapeutic response underscores the needfor precision hepatology. MicroRNAs (miRNAs), a class of small noncoding RNAs of approximately20–22 nucleotides, have emerged as promising molecular tools owing to their abundanthepatic expression, dynamic regulation across disease stages, and high stability in biologicalfluids. In this review, we examine the roles of miRNAs across three pillars of precision medicinein liver disease. First, circulating miRNA panels enable noninvasive diagnosis of metabolicdysfunction-associated steatohepatitis, significant liver fibrosis, and early-stage HCC, offeringa practical alternative to liver biopsy. Second, miRNAs serve as prognostic biomarkers capableof stratifying patients according to fibrosis progression and risk of HCC recurrence. Third,miRNA-based therapeutics―including mimics and antagomirs delivered via lipid nanoparticlesor exosomes―have demonstrated promising efficacy in preclinical models. Broader clinicalimplementation will require standardized protocols, validated quantification platforms, andinternational regulatory consensus, all of which will be essential for establishing miRNAs aspractical tools in precision hepatology.

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