MicroRNA dysregulation and therapeutic opportunities in esophageal diseases

MicroRNAs (miRNAs) are a class of small endogenous RNA molecules between 18 and 25 nucleotides long. The primary function of miRNAs is in the posttranscriptional regulation of mRNA targets through RNA interference culminating in mRNA degradation or trans-lational repression. MiRNAs are fundamental in physiological and pathological processes such as cell proliferation, differentiation, apo-ptosis, and inflammation. Among this includes the uncovered potential of miRNAs in overall esophageal disease with a focus on the clinicopathologic allergic disease eosinophilic esophagitis (EoE), gastroesophageal reflux disease (GERD), and the tumorigenic contin-uum from Barrett's esophagus (BE) toward esophageal adenocarcinoma (EAC). Although these pathologies are distinct from one another, they share pathophysiological elements such as an intense inflammatory milieu, esophageal dysfunction, and as presented in this review, an overlap in miRNA expression which contributes to overall esophageal disease. The overlap in the dysregulated miRNA transcriptome of these pathologies highlights the key role miRNAs play in contributing to esophageal disease progression. Owing to this notable dysregulation, there is an attractive utility for miRNAs as diagnostic and prognostic biomarkers in esophageal diseases that already require invasive endoscopies and biopsy retrieval. In this review miRNAs within EoE, GERD, BE, EAC, and esophageal achalasia are discussed, as well as reviewing a core set of miRNAs shared in the disease progression among some of these pathologies, along with the potential utility of targeting miRNAs as therapeutic options in overall esophageal disease.

Automated summary

MicroRNAs (miRNAs) are small endogenous RNA molecules that regulate mRNA targets through RNA interference. They play a crucial role in physiological and pathological processes including cell proliferation, differentiation, apoptosis, and inflammation. This review discusses the potential of miRNAs in overall esophageal disease, focusing on eosinophilic esophagitis (EoE), gastroesophageal reflux disease (GERD), and the progression from Barrett's esophagus (BE) to esophageal adenocarcinoma (EAC). The dysregulation of miRNA expression in these diseases highlights their key role in disease progression and suggests their potential as diagnostic and prognostic biomarkers. Furthermore, targeting miRNAs could be a therapeutic option for esophageal disease.