A Systematic Review of the Role of microRNAs in the Diagnosis, Clinical Aspect and Follow-Up of Acromegaly

Abstract

Acromegaly is a disorder characterized by excessive growth hormone (GH) production, often resulting in serious health complications and is primarily caused by GH-secreting pituitary adenomas. Recent research has highlighted the potential role of microRNAs (miRNAs) in regulating various aspects of acromegaly, including diagnosis, treatment, and prognosis. This systematic review aims to consolidate current knowledge on the roles of miRNAs in acromegaly and to evaluate their potential as biomarkers and therapeutic targets. Methods: A comprehensive literature search was conducted in four databases: Embase, PubMed/MEDLINE, Scopus, and Web of Science. The search strategy focused on studies examining miRNAs in the context of acromegaly. Initially, 29 studies were identified as potentially eligible. After rigorous screening based on predefined inclusion and exclusion criteria, 14 studies were included in the final review. Data extraction and quality assessment were performed independently by two reviewers to ensure accuracy and relevance. Results: The included studies presented a wide range of findings regarding the involvement of miRNAs in acromegaly. Key results include several miRNAs, such as miR-34a, miR-145, miR-216a-5p, and miR-652-3p, which were found to be significantly dysregulated in GH-secreting pituitary tumors. These miRNAs were associated with tumor proliferation, invasiveness, and response to somatostatin analog (SSA) therapy. Specific miRNAs, including miR-625-5p, miR-503-5p, miR-181a-2-3p, and miR-130b-3p, were identified as potential biomarkers for distinguishing GH-secreting pituitary tumors from non-functional tumors and healthy individuals. Studies also demonstrated that miRNAs impact key signaling pathways, such as JAK2 and the PTEN-AKT pathway, which are involved in tumor growth and hormone regulation.