Exploring the pathologic role of microRNAs as diagnostic and therapeutic markers in endometriosis: A narrative review

Mehri Khatami, Mohammad Heidari, Mojgan Hajisafari Tafti
In: Journal of Translational Medical Research · 2025 · vol. 32(2) , pp. 79–97 · doi:10.61882/jbums.32.2.79 · W4414892931
article OA: hybrid CC0
📄 Open PDF Full text JSON View on OpenAlex View at publisher
⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-13 ⓘ

This narrative review explores the pathologic role of microRNAs in endometriosis, examining their potential as both diagnostic and therapeutic markers.

One-sentence paraphrase of the abstract; not a substitute for reading it. No clinical advice. How this works

⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-17 · read from full text ⓘ

This narrative review examines the pathophysiological role of microRNAs in endometriosis, highlighting their function as post-transcriptional regulators of inflammation, cell proliferation, and apoptosis. The authors identify specific miRNAs, such as miR-145, miR-200b, and miR-451, which exhibit altered expression in endometriotic tissues and influence inflammatory signaling pathways like NF-κB and growth pathways including VEGF and Wnt/β-catenin. While these epigenetic regulators show promise as diagnostic markers and therapeutic targets due to their impact on disease progression and invasion, the paper notes that further research is needed to clarify their precise mechanisms and clinical utility. This paper is centrally about endometriosis — specifically exploring the diagnostic and therapeutic potential of microRNA biomarkers within its pathophysiology.

Read from the paper's body, not the abstract. Not a substitute for reading the paper. No clinical advice. How this works

Full text 16,742 characters · extracted from oa-doi-fallback · 2 sections · click to expand

Abstract

(1870 Views) | Endometriosis is a chronic inflammatory condition characterized by the presence of endometrial-like tissue outside the uterus. The pathophysiology of this condition is complex and multifactorial, with recent research indicating that microRNAs may play an important role as post-transcriptional regulators in managing pathogenic processes, including inflammation, cell proliferation, vascularization, and resistance to apoptosis. This study examines the role of miRNAs in the pathophysiology of endometriosis and explores the potential mechanisms through which they influence the disease progression. Current findings suggest that certain miRNAs (such as miR-145, miR-200b, and miR-451) are expressed differently in endometriotic tissues and are associated with the negative regulation of their target genes within inflammatory signaling pathways, such as nuclear factor- Kappa B (NF-κB) and cell growth pathways (e.g., VEGF and Wnt/β-catenin). Furthermore, the impaired expression of miRNAs may contribute to increased cell invasion and metastasis, which are critical characteristics of endometriosis. Given that endometriosis is recognized as an inflammatory disease, it is reasonable to consider the relationship between the onset of endometriosis and alterations in miRNA expression. Recent studies have also indicated changes in the expression levels of several miRNAs in both endometriotic lesions and ectopic endometrium of women with endometriosis, compared to healthy individuals. This study concludes that miRNAs, functioning as epigenetic regulators, hold significant promise as diagnostic markers and therapeutic targets in endometriosis. Nevertheless, additional research is required to elucidate their precise mechanisms of action and clinical significance. | Type of Study: Review | Subject: Reproductive Biology Received: 2025/05/10 | Accepted: 2025/06/30 | ePublished ahead of print: 2025/08/12 | ePublished: 2025/09/6 Received: 2025/05/10 | Accepted: 2025/06/30 | ePublished ahead of print: 2025/08/12 | ePublished: 2025/09/6

References

1. Chen Y, Liu C, Wang X, Liu Y, Liu H. Global, Regional and National Burden of Infertility due to Endometriosis: Results From the Global Burden of Disease Study 2021 and Forecast to 2044. BJOG: An International Journal of Obstetrics & Gynaecology. 2025; 132(7): 944-60. DOI: 10.1111/1471-0528.18108 [DOI:10.1111/1471-0528.18108] [PMID] 2. Young K, Fisher J, Kirkman M. Endometriosis and fertility: women's accounts of healthcare. Hum Reprod. 2016; 31(3): 554-62. DOI: 10.1093/humrep/dev337 [DOI:10.1093/humrep/dev337] [PMID] 3. Shen DY, Li J, Hu P, Qi C, Yang H. Global, regional, and national prevalence and disability-adjusted life-years for endometriosis in 204 countries and territories, 1990-2019: findings from a global burden of disease study. Eur J Obstet Gynecol Reprod Biol X. 2025; 25: 100363. DOI: 10.1016/j.eurox.2024.100363 [DOI:10.1016/j.eurox.2024.100363] [PMID] [] 4. Momenimovahed Z, Mazidimoradi A, Allahqoli L, Salehiniya H. The Role of CA‐125 in the Management of Ovarian Cancer: A Systematic Review. Cancer Rep (Hoboken). 2025; 8(3): e70142. DOI: 10.1002/cnr2.70142 [DOI:10.1002/cnr2.70142] [PMID] [] 5. Domino W, Śnieżna J, Florczak W, Dzwonnik K, Zelik U, Włodyka J, et al. Innovative Diagnostic Approaches and Treatment Strategies for Endometriosis: Current Trends and Future Direction-Review. Qual Sport. 2025; 37: 57149-57149. DOI: 10.12775/QS.2025.37.57149. [DOI:10.12775/QS.2025.37.57149] 6. Minamikawa T, Yachida N, Takahashi K, Saito K, Sekizuka T, Akashi H, et al. Endometrial Cancer with and without Endometriosis: Clinicopathological Differences. Cancers. 2023; 15(23): 5635. DOI: 10.3390/cancers15235635 [DOI:10.3390/cancers15235635] [PMID] [] 7. Maggiore ULR, Chiappa V, Ceccaroni M, Roviglione G, Savelli L, Ferrero S, et al. Epidemiology of infertility in women with endometriosis. Best Pract Res Clin Obstet Gynaecol. 2024: 92:102454. DOI: 10.1016/j.bpobgyn.2023.102454 [DOI:10.1016/j.bpobgyn.2023.102454] [PMID] 8. Shi J, Xu Q, Yu S, Zhang T. Perturbations of the endometrial immune microenvironment in endometriosis and adenomyosis: their impact on reproduction and pregnancy. Semin Immunopathol. 2025; 47(1): 16. DOI: 10.1007/s00281-025-01040-1 [DOI:10.1007/s00281-025-01040-1] [PMID] [] 9. You W, Wang S, Li C, Ma Y, Liu F, Shen Y, et al. Stem cell theory: A new horizon for the treatment of endometriosis by targeting mesenchymal stem cell. Int J Gynaecol Obstet. 2025; 170(2): 588-600. [DOI:10.1002/ijgo.70046] [PMID] 10. Bałoniak J, Szymańska Z, Leszyńska A, Bałoniak Z, Jonkisz A, Skurzyńska G, et al. Diagnostic Challenges and Innovations in Thoracic Endometriosis (TE): Exploring the Role of Imaging and Biomarkers. A narrative review. Quality in Sport. 2025; 37: 57087-57087. DOI: 10.12775/QS.2025.37.57087. [DOI:10.12775/QS.2025.37.57087] 11. Chou Y-C, Chen M-J, Chen P-H, Chang C-W, Yu M-H, Chen Y-J, et al. Integration of genome-wide association study and expression quantitative trait locus mapping for identification of endometriosis-associated genes. Sci Rep. 2021; 11(1): 478. DOI: 10.1038/s41598-020-79515-4 [DOI:10.1038/s41598-020-79515-4] [PMID] [] 12. Noormohammad M, Sadeghi S, Tabatabaeian H, Ghaedi K, Talebi A, Azadeh M, et al. Upregulation of miR-222 in both Helicobacter pylori-infected and noninfected gastric cancer patients. J Genet. 2016; 95(4): 991-5. DOI: 10.1007/s12041-016-0728-9 [DOI:10.1007/s12041-016-0728-9] [PMID] 13. Tabrizi F, Khatami M, Heidari MM, Bragança J, Tatari H, Namnabat M, et al. Novel and deleterious nucleotide variations in the HAND1 gene probably affect miRNA target sites and protein function in pediatric patients with congenital heart disease. Mol Biol Rep. 2024; 51(1): 468. DOI: 10.1007/s11033-024-09410-y [DOI:10.1007/s11033-024-09410-y] [PMID] 14. Motamedi F, Khatami M, Heidari MM, Azadeh M, Karami N. Evaluation of the expression of LINCOO475 and FOXO1 genes as tumor suppressor genes in breast cancer: Correlation of bioinformatics tools and experimental approaches. Gene Rep. 2024; 36: 101980. DOI: 10.1016/j.genrep.2024.101980 [DOI:10.1016/j.genrep.2024.101980] 15. Naji P, Heidari MM, Khatami M, Zare-Zardini H, Chamani R. MicroRNAs as a new molecular biomarker for diagnosis and prognosis of T-cell acute lymphoblastic leukemia (T-ALL): a systematic review. Iran J Ped Hematol Oncol. 2020; 10 (3): 184-99. URL: http://ijpho.ssu.ac.ir/article-1-560-en.html 16. Khatami M, Ghorbani S, Adriani MR, Bahaloo S, Naeini MA, Heidari MM, et al. Novel Point Mutations in 3'-Untranslated Region of GATA4 Gene Are Associated with Sporadic Non-syndromic Atrial and Ventricular Septal Defects. Curr Med Sci. 2022; 42 (1): 129-43. DOI: 10.1007/s11596-021-2428-9 [DOI:10.1007/s11596-021-2428-9] [PMID] 17. Rashid G, Khan NA, Elsori D, Youness RA, Hassan H, Siwan D, et al. miRNA expression in PCOS: Unveiling a paradigm shift toward biomarker discovery. Arch Gynecol Obstet. 2024; 309 (5): 1707-23. DOI: 10.1007/s00404-024-07379-4 [DOI:10.1007/s00404-024-07379-4] [PMID] 18. Bofill-De Ros X, Vang Ørom UA. Recent progress in miRNA biogenesis and decay. RNA biol. 2024; 21(1): 1-8. DOI: 10.1080/15476286.2023.2288741 [DOI:10.1080/15476286.2023.2288741] [PMID] [] 19. Castro-Magdonel BE, Orjuela M, Alvarez-Suarez DE, Camacho J, Cabrera-Muñoz L, Sadowinski-Pine S, et al. Circulating miRNome detection analysis reveals 537 miRNAS in plasma, 625 in extracellular vesicles and a discriminant plasma signature of 19 miRNAs in children with retinoblastoma from which 14 are also detected in corresponding primary tumors. PLoS One. 2020; 15(4): e0231394. DOI: 10.1371/journal.pone.0231394 [DOI:10.1371/journal.pone.0231394] [PMID] [] 20. Cui Y, Qi Y, Ding L, Ding S, Han Z, Wang Y, et al. miRNA dosage control in development and human disease. Trends Cell Biol. 2024; 34(1): 31-47. DOI: 10.1016/j.tcb.2023.05.009 [DOI:10.1016/j.tcb.2023.05.009] [PMID] 21. Javadi M, Rad JS, Farashah MSG, Roshangar L. An insight on the role of altered function and expression of exosomes and microRNAs in female reproductive diseases. Reprod Sci. 2022; 29(5): 1395-407. DOI: 10.1007/s43032-021-00556-9 [DOI:10.1007/s43032-021-00556-9] [PMID] 22. Bjorkman S, Taylor HS. MicroRNAs in endometriosis: biological function and emerging biomarker candidates. Biol Reprod. 2019; 101(5): 1167-78. DOI: 10.1093/biolre/ioz014 [DOI:10.1093/biolre/ioz014] [PMID] [] 23. Zhuo Z, Wang C, Yu H. Plasma microRNAs can be a potential diagnostic biomarker for endometriosis. Ginekol Pol. 2022; 93(6): 450-9. DOI: 10.5603/GP.a2021.0127 [DOI:10.5603/GP.a2021.0127] [PMID] 24. Ohlsson Teague EMC, Van der Hoek KH, Van der Hoek MB, Perry N, Wagaarachchi P, Robertson SA, et al. MicroRNA-regulated pathways associated with endometriosis. Mol Endocrinol. 2009; 23 (2): 265-75. DOI: 10.1210/me.2008-0387 [DOI:10.1210/me.2008-0387] [PMID] [] 25. Nothnick WB, editor MicroRNAs and endometriosis: distinguishing drivers from passengers in disease pathogenesis. Semin Reprod Med. 2017; 35(2): 173-180. New York: Thieme Medical Publishers. DOI: 10.1055/s-0037-1599089 [DOI:10.1055/s-0037-1599089] [PMID] [] 26. Kolenda T, Guglas K, Kopczyńska M, Sobocińska J, Teresiak A, Bliźniak R, et al. Good or not good: Role of miR-18a in cancer biology. Rep Pract Oncol Radiother. 2020; 25(5): 808-19. DOI: 10.1016/j.rpor.2020.07.006 [DOI:10.1016/j.rpor.2020.07.006] [PMID] [] 27. Ramon-Nunez LA, Martos L, Fernandez-Pardo A, Oto J, Medina P, Espana F, et al. Comparison of protocols and RNA carriers for plasma miRNA isolation. Unraveling RNA carrier influence on miRNA isolation. Plos one. 2017; 12(10): e0187005. DOI: 10.1371/journal.pone.0187005 [DOI:10.1371/journal.pone.0187005] [PMID] [] 28. Begum Y, Pandit A, Shukla D, Gupta R, DasMahapatra P, Srivastava AK, et al. Suppression of endometriosis by miRNA-34a via inhibition of matrix metalloproteinase-2: An alternative pathway to impede invasion. ncRNA Res. 2025; 12: 92-101. DOI: 10.1016/j.ncrna.2025.02.001 [DOI:10.1016/j.ncrna.2025.02.001] [PMID] [] 29. Smolarz B, Szaflik T, Romanowicz H, Bryś M, Forma E, Szyłło K. Analysis of VEGF, IGF1/2 and the Long Noncoding RNA (lncRNA) H19 Expression in Polish Women with Endometriosis. Int J Mol Sci. 2024; 25(10): 5271. DOI: 10.3390/ijms25105271 [DOI:10.3390/ijms25105271] [PMID] [] 30. Kluz N, Kowalczyk E, Wasilewska M, Gil-Kulik P. Diagnostic Value and Molecular Function of MicroRNAs in Endometrial Diseases: A Systematic Review. Cancers 2024; 16(13): 2416. DOI: 10.3390/cancers16132416 [DOI:10.3390/cancers16132416] [PMID] [] 31. Koutalia N, Gkrozou F, Vatopoulou A, Lentzaris D, Skentou C, Paschopoulos M, et al. Role of Molecular Biomarkers in Endometriosis-Related Infertility: A Narrative Review of the Literature. Cureus. 2024; 16(4): e59288. DOI: 10.7759/cureus.59288 [DOI:10.7759/cureus.59288] [PMID] [] 32. Begum MIA, Chuan L, Hong S-T, Chae H-S. The pathological role of miRNAs in endometriosis. Biomedicines. 2023; 11(11): 3087. DOI: 10.3390/biomedicines11113087 [DOI:10.3390/biomedicines11113087] [PMID] [] 33. Wang S, Duan H, Wang S, Guo Z, Lin Q. miR-141-3p regulates the proliferation and apoptosis of endometrial-myometrial interface smooth muscle cells in adenomyosis via JAK2/STAT3 pathway. Biochem Genet. 2024; 62(3): 2049-65. DOI: 10.1007/s10528-023-10508-4 [DOI:10.1007/s10528-023-10508-4] [PMID] 34. Rekker K, Saare M, Roost AM, Kaart T, Soritsa D, Karro H, et al. Circulating miR-200-family micro-RNAs have altered plasma levels in patients with endometriosis and vary with blood collection time. Fertil Steril. 2015; 104(4): 938-46. e932. DOI: 10.1016/j.fertnstert.2015.06.029 [DOI:10.1016/j.fertnstert.2015.06.029] [PMID] 35. Joshi N, Su R, Chandramouli G, Khoo S, Jeong J, Young S, et al. Altered expression of microRNA-451 in eutopic endometrium of baboons (Papio anubis) with endometriosis. Hum Reprod. 2015; 30(12): 2881-91. DOI: 10.1093/humrep/dev229 [DOI:10.1093/humrep/dev229] [PMID] [] 36. Zubrzycka A, Migdalska-Sęk M, Jędrzejczyk S, Brzeziańska-Lasota E. Circulating miRNAs related to Epithelial-Mesenchymal Transitions (EMT) as the new molecular markers in endometriosis. Curr Issues Mol Biol. 2021; 43(2): 900-16. DOI: 10.3390/cimb43020064 [DOI:10.3390/cimb43020064] [PMID] [] 37. Börschel CS, Stejskalova A, Schäfer SD, Kiesel L, Götte M. miR-142-3p reduces the size, migration, and contractility of endometrial and endometriotic stromal cells by targeting integrin-and Rho GTPase-related pathways that regulate cytoskeletal function. Biomedicines. 2020; 8(8): 291. DOI: 10.3390/biomedicines8080291 [DOI:10.3390/biomedicines8080291] [PMID] [] 38. Zhu R, Nasu K, Hijiya N, Yoshihashi M, Hirakawa T, Aoyagi Y, et al. hsa-miR-199a-3p inhibits motility, invasiveness, and contractility of ovarian endometriotic stromal cells. Reprod Sci. 2021; 28(12): 3498-507. DOI: 10.1007/s43032-021-00604-4 [DOI:10.1007/s43032-021-00604-4] [PMID] 39. Azari ZD, Aljubran F, Nothnick WB. Inflammatory MicroRNAs and the pathophysiology of endometriosis and atherosclerosis: common pathways and future directions towards elucidating the relationship. Reprod Sci. 2022; 29(8): 2089-104. DOI: 10.1007/s43032-022-00955-6 [DOI:10.1007/s43032-022-00955-6] [PMID] 40. Bagheri M, Khansarinejad B, Mondanizadeh M, Azimi M, Alavi S. MiRNAs related in signaling pathways of women's reproductive diseases: an overview. Mol Biol Rep. 2024; 51(1): 414. DOI: 10.1007/s11033-024-09357-0 [DOI:10.1007/s11033-024-09357-0] [PMID] 41. Indumati S, Apurva B, Gaurav G, Nehakumari S, Nishant V. The Role of MicroRNAs in Development of Endometrial Cancer: A Literature Review. J Reprod Infertil. 2023; 24(3): 147-165. DOI: 10.18502/jri.v24i3.13271 [DOI:10.18502/jri.v24i3.13271] [PMID] [] 42. Nazari Hagh Y, Ahmadifard M, Esmaelzadeh S, Abbaszadeh S, Shokrzadeh N. Decreased expression of miR-200a and miR-223-3p in endometriosis during the secretory phase of menstrual cycle: Insights from a case-control study on molecular biomarkers and disease-related infertility. Int J Reprod Biomed. 2025; 22(12): 1003-1014. DOI: 10.18502/ijrm.v22i12.18066 [DOI:10.18502/ijrm.v22i12.18066] [PMID] [] 43. Di Pietro C, Caruso S, Battaglia R, Iraci Sareri M, La Ferlita A, Strino F, et al. MiR‐27a‐3p and miR‐124‐3p, upregulated in endometrium and serum from women affected by Chronic Endometritis, are new potential molecular markers of endometrial receptivity. Am J Reprod Immunol. 2018; 80(3): e12858. DOI: 10.1111/aji.12858 [DOI:10.1111/aji.12858] [PMID] 44. Shetty A, Venkatesh T, Kabbekodu SP, Tsutsumi R, Suresh PS. LncRNA-miRNA-mRNA regulatory axes in endometrial cancer: a comprehensive overview. Arch Gynecol Obstet. 2022; 306(5): 1431-47. DOI: 10.1007/s00404-022-06423-5 [DOI:10.1007/s00404-022-06423-5] [PMID] 45. Chandrakanth A, Firdous S, Vasantharekha R, Santosh W, Seetharaman B. Exploring the effects of endocrine-disrupting chemicals and miRNA expression in the pathogenesis of endometriosis by unveiling the pathways: a systematic review. Reprod Sci. 2024; 31(4): 932-41. DOI: 10.1007/s43032-023-01412-8 [DOI:10.1007/s43032-023-01412-8] [PMID] Send email to the article author | Rights and permissions | | | This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |

Text is read by the "Ask this paper" AI Q&A widget below. Extraction quality varies by source — PMC NXML preserves structure cleanly, OA-HTML may include some navigation residue, and OA-PDF can have broken hyphenation. The publisher copy (via DOI) is the canonical version.

My notes (saved in your browser only)

⚙ Ask this paper AI returns verbatim quotes from the full text · source: oa-doi-fallback ⓘ

Answers must be backed by verbatim quotes from this paper's full text. Hallucinated quotes are dropped automatically; if no verbatim passage answers the question, we say so. How this works

Condition tags

endometriosis

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (44)

Source provenance

openalex
last seen: 2026-06-10T17:14:06.276822+00:00
License: CC0 · commercial use OK