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MicroRNA-21 (miR-21) is a well-characterized oncogenic microRNA (oncomir) that is significantly upregulated in various cancers and fibrotic diseases (PubMed: 21822215). It exerts its biological effects by binding to the 3' untranslated regions (UTRs) of specific messenger RNA (mRNA) targets, leading to their post-transcriptional silencing (PubMed: 18485877). These miR-21-regulated mRNA targets primarily consist of tumor suppressors and pro-apoptotic genes, such as Phosphatase and tensin homolog (PTEN), Programmed cell death protein 4 (PDCD4), and Reversion-inducing cysteine-rich protein with Kazal motifs (RECK) (PubMed: 24311574). The suppression of these targets promotes key pathological processes, including uncontrolled cell proliferation, evasion of apoptosis, and the induction of the epithelial-mesenchymal transition (EMT) (PubMed: 22330140). In fibrotic conditions, miR-21 targets like Smad7 and Spry1 are downregulated, which accelerates TGF-beta signaling and collagen deposition (PubMed: 20924344). Therapeutic strategies focus on using antisense oligonucleotides, such as Lademirsen (RG-012), to inhibit miR-21 and thereby restore the expression of these critical mRNA targets (PubMed: 32665318). Restoring the levels of these mRNAs helps to re-establish normal cellular homeostasis and has shown promise in treating Alport syndrome and various solid tumors. Monitoring the protein levels of targets like PTEN or PDCD4 serves as a valuable biomarker for assessing the efficacy of anti-miR-21 therapies in clinical trials.
Antisense oligonucleotides (antagomirs) bind to and sequester miR-21, preventing it from binding to its mRNA targets, which leads to the restoration of target protein expression and inhibition of disease progression.
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