Clinical Importance of miRNA in Diabetic Neuropathy: Pathophysiology, Diagnosis, and Therapeutic Potential

Diabetic Neuropathy (DN) is the major chronic complication in diabetic patients. Exact pathophysiological mechanisms of DN are not explored well, although axon Schwann cell and microvascular endothelial communication network failure play a major contributing role in DN. The multiple pathophysiological mechanisms of DN are regulated by microRNAs (miRNAs), including inflammation, vascularization, angiogenesis, posttranscriptional regulation, intercellular communication, and signalling pathways. Various types of miRNA affect the gene expressions within cells, but their profiles often change during DN, including SMAD, PI3K, NF-KB, and MAPK. DN has been associated with the miRNAs-9, miRNA-106, miRNA-182, miRNA-23a, miRNA- 23b, miRNA-23c, miRNA-503, miRNA-203, miRNA-145, and miRNA-126. MiRNA dysregulation is one of the first molecular changes seen in diabetics. Therefore, miRNAs have potential as therapeutic targets and biomarkers. This study aims to discuss the importance of miRNA in clinical pathophysiology, diagnosis, signalling pathways, and therapeutic targets for DN.