MicroRNAs (miRNA) are short (~22 nucleotides in length), non-coding RNAs that regulate gene expression by binding to specific mRNA targets and promoting their degradation and/or translational inhibition. MicroRNAs circulating in the peripheral blood are reported to modulate signaling between cells, to be diagnostic markers for cancers and are also acknowledged as an important player in the pathophysiology of spinal cord injury (SCI). Recent studies suggest that changes in gene expression following neural injury can result from the dysregulation of miRNAs, which play important roles in diverse neurobiological processes such as: cell differentiation, growth, proliferation and neuronal activity, as well as the pathogenic processes of central nervous system (CNS) injury including inflammation, oxidation, demyelination and apoptosis. The severity of the initial injury plays a significant role in determining the nature and amplitude of the secondary injury and consequently the appropriate interventions. However, current clinical measures for characterizing injury se-verity are based on functional tests that cannot be applied immediately following injury because they are often compromised by shock, other attendant injuries and drugs or alcohol. Neural stem cells are recognized as the most promising natural resource for the treatment of CNS diseases due to their proliferation, renewal, and passage capacities in vivo and in vitro. Recent studies have shown that transplan-ted stem cells confer neuroprotection primarily through a paracrine mechanism, and small extracellular vesicles play an important role in this process; they have been proposed to serve as an ideal carrier to deliver miRNAs to recipient cells. This mini-review summarizes new insights into the role of miRNAs in the pathophysiology, diagnosis, and treatment of SCI.

Department of Neuroscience 2nd Faculty of Medicine Charles University Prague

Institute of Experimental Medicine CAS v v i Prague

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