The Role of microRNA Markers in the Diagnosis, Treatment, and Outcome Prediction of Spinal Cord Injury

Spinal cord injury (SCI) is a devastating condition, and treatment aims to control secondary injury and improve regeneration. MicroRNAs (miRNAs) are suggested to heavily regulate both the secondary injury and regenerative processes. Measuring specific biomarkers, like miRNAs, could improve understanding of disease processes, guide treatment, and predict clinical outcomes after SCI. Certain miRNAs play important roles in inflammation, cell death, and regeneration, making them useful as diagnostic tools. miRNAs can also be used in the treatment of SCI and its symptoms. Clinical evidence suggests that miRNAs could be robust diagnostic and therapeutic tools for treating patients with SCI, warranting further clinical studies to clarify the importance of each miRNA subtype in SCI management.

• 1
  miRNAs play a pivotal role in the shift from hypertrophy to hyperplasia in astrogliosis. Specifically, miR-21 is highly expressed in astrocytes near and at the lesion site during astrogliosis and is directly responsible for the shift from hypertrophy to hyperplasia, where it suppresses GFAP and VIM.
• 2
  Apoptosis after SCI is caused by either downregulation of miRNAs that target proapoptotic genes or upregulation of miRNAs that target antiapoptotic genes. These regulatory effects provide multiple avenues for potential therapeutic strategies involving managing the balance of proapoptotic and antiapoptotic miRNAs.
• 3
  The expressions of various miRNAs that help regulate the body’s inflammatory processes are altered in SCI and are thus an important target for potential therapies. For example, miR-146a targets the proinflammatory enzyme cyclooxygenase-2 (COX-2) and the proteins encoded by the genes, IL1B and IL6.