MicroRNA dysregulation in oral pathology: Implications for diagnosis and therapy

Dear Editor, We are writing to provide an in-depth overview of the intriguing role of microRNA (miRNA) dysregulation in the realm of oral pathology and medicine. MicroRNAs, small non-coding RNAs, are increasingly recognized as pivotal players in the post-transcriptional regulation of gene expression, and their aberrant expression patterns have gathered significant attention within the context of various diseases, including oral pathologies [1].
Recent research has unveiled the multifaceted involvement of miRNAs in oral health and diseases, which has transformative implications for both diagnosis and therapeutic strategy. Here, we aimed to explore some of the key findings in this rapidly increasing field.

Oral squamous cell carcinoma: the role of miRNA families

One compelling area of investigation centers around the miR-200 family, specifically miR-200b. This miRNA has been shown to modulate the epithelial-mesenchymal transition (EMT) in oral squamous cell carcinoma (OSCC), a critical process in tumor invasion and metastasis [2]. Downregulation of miR-200b is associated with increased EMT markers, contributing to the aggressive behavior of OSCC cells. Additionally, miR-98 has been reported to downregulate cell lines and tissues in OSCC, demonstrating an anti-cancerous effect [3].
MiR-20a, a member of the miR-17-92 cluster, has gained attention for its potential role in OSCC. Wang et al. [4] conducted a meta-analysis and systematic review, indicating that miR-20a is associated with human cancers and has prognostic implications. Furthermore, Nakamura et al. [5] suggested that miR-20a inhibits cell migration in oral cancer and may serve as a prognostic marker for OSCC. Geng et al. [6] also identified miR-20a as a potential biomarker for early screening of non-small cell lung cancer (NSCLC). These studies collectively support the relevance of miR-20a in malignancies, including its potential role in OSCC.
Huang et al. [7] highlighted miR-20a as a promising biomarker for predicting prognosis in human cancer through a meta-analysis. Additionally, Hue et al.’s [8] study demonstrated that human papillomavirus type 16 E7 (HPV16E7) inhibits the proliferation, invasion, and meta­stasis of OSCC by up-regulating the expression of miR-20a. These findings shed light on the intricate regulatory networks involving miR-20a in cancer progression.
However, the activation of genetic tracts in oral carcinoma is influenced by various external parameters. Factors, such as patient and tumor characteristics, and clinical presentation and behavior of oral squamous cell carcinomas have been found to influence the prognosis based on the type of epithelia and its origin [8]. Additio­nally, the presence of tissue eosinophilia has been asso­ciated with stromal invasion in cutaneous squamous neoplasia, indicating a potential influence on the activation of genetic tracts in oral carcinoma [9, 10]. Furthermore, genetic influences have been observed in almost all tracts with similar heritability for various parameters, such as fractional anisotropy (FA), radial diffusivity (RD), and axial diffusivity (AD) in white matter tracts, suggesting a genetic component in the activation of genetic tracts [11]. Moreover, host genetic associations have been identified with the salivary microbiome in oral cancer, indicating a potential link between genetic factors and oral micro­biome in the context of oral carcinoma [12].
In addition to genetic factors, external parameters, such as lymph node involvement, have been reco­gnized as important prognosticators in oral squamous cell carcinoma patients, indicating a potential influence on the activation of genetic tracts [13]. The expression of markers, such as Ki-67 and endoglin (CD105) in oral squamous cell carcinoma, indicates the multifactorial nature of the disease, demonstrating that multiple external parameters may influence the activation of genetic tracts in oral carcinoma [14]. In addition, tobacco use has been established as a well-known risk factor for potentially malignant disorders and oral squamous cell carcinoma, highlighting the influence of environmental factors on the activation of genetic tracts in oral carcinoma [15].

Oral lichen planus: MiR-21 as a biomarker

In the context of oral lichen planus (OLP), miR-21 has emerged as a potential biomarker for disease progression, and studies have demonstrated its upregulation in OLP tissues [16]. Upregulated expression of miR-21 levels may serve as a diagnostic indicator, offering insights into the molecular mechanisms underlying OLP pathogenesis.

Therapeutic potential: miRNA-based approaches

MiRNA-based therapies have garnered considerable interest in the management of oral pathologies. For example, miR-375 mimics have shown promise in suppressing the growth of oral cancer cells [17]. MiR-375 is reported to be markedly downregulated in oral carcinoma tissues, playing an oncogenic role in oral carcinogenesis [18]. These therapeutic interventions hold a potential to revolutionize the treatment landscape, providing targeted and personalized approaches for patients with oral diseases.

Inflammatory disorders: MiR-146a in periodontitis

Inflammatory oral disorders, such as periodontitis, have also been explored in the context of miRNA regu­lation. MiR-146a has emerged as a key player, exerting anti-inflammatory effects by targeting key signaling molecules [19]. Development of inflammatory diseases, particularly periodontitis, is linked to the dysfunction and/ or downregulation of miR-146a [20]. Therefore, understanding of the intricate regulatory networks involving miR-146a may pave a way for innovative anti-inflammatory therapies [21].

Navigating economic realities: considerations for miRNA-based procedures

While miRNA research in oral pathology holds immense potential, the translation of these findings into practical clinical applications necessitates careful consideration of economic factors. It is essential to acknowledge that the application of miRNA-based approaches in clinical settings can pose challenges, especially in terms of costs. Technologies involved in miRNA analysis, such as quantitative real-time polymerase chain reaction (PCR) and next-generation sequencing, are sophisticated innovations, and can be resource-intensive. From sample collection to data interpretation, each step demands specialized equipment and skilled personnel, contri­buting to the overall cost of implementation. As the field advances, adopting economic implications in integrating miRNA-based diagnostics and therapies into routine cli­nical practice becomes paramount. Strategies to optimize workflows, streamline processes, and enhance cost-effectiveness will be crucial to ensure the accessibility and feasibility of these promising molecular approaches in the broader healthcare landscape. Balancing the benefits of precision medicine with the associated costs will be instrumental in realizing the full impact of miRNA-based diagnostics and therapeutics for oral diseases.
In conclusion, the exploration of miRNA dysregulation in oral pathology represents a promising frontier in biomedical research. These small molecules employ significant influence over crucial processes, from tumor progression to inflammation, within the oral cavity. As we explore deeper into this intricate molecular landscape, new diagnostic tools and therapeutic strategies will likely emerge, offering hope for improved patient outcomes.

Disclosures

1. Institutional review board statement: Not appicable.
2. Assistance with the article: None.
3. Financial support and sponsorship: None.
4. Conflicts of interest: The authors declare no potential conflicts of interest concerning the research, authorship, and/or publication of this article.

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