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MicroRNA-122 (miR-122) is a highly conserved, liver-specific non-coding RNA that accounts for approximately 70% of the total microRNA population in the adult liver (Jopling, 2012, Liver Int). It plays a pivotal role in maintaining hepatic phenotype and regulating diverse physiological processes, including cholesterol biosynthesis, fatty acid metabolism, and iron homeostasis (Esau et al., 2006, Cell Metab). miR-122 is uniquely required for the life cycle of the Hepatitis C virus (HCV); it binds to two sites in the 5' untranslated region of the viral RNA, providing stability and promoting replication (Jopling et al., 2005, Science). In oncology, miR-122 is frequently downregulated in hepatocellular carcinoma, where it functions as a tumor suppressor by inhibiting cell proliferation and invasion (Coulouarn et al., 2009, Hepatology). Therapeutic targeting of miR-122 primarily utilizes antisense oligonucleotides (antagomirs) like Miravirsen to sequester the microRNA, thereby inhibiting HCV replication or modulating metabolic pathways (Janssen et al., 2013, NEJM). However, long-term inhibition poses challenges due to its role in preventing malignant transformation in liver tissue (Hsu et al., 2012, J Clin Invest).
Antisense oligonucleotides (ASOs) or antagomirs bind to and sequester mature miR-122, preventing it from binding to its natural mRNA targets or the Hepatitis C virus (HCV) genome, thereby inhibiting viral replication and modulating host gene expression (Janssen et al., 2013, NEJM; van der Ree et al., 2017, Lancet).
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