S253 Exploring the Role of miRNA Expression Profiles in Severe Acute Pancreatitis-Associated Acute Lung Injury: Mechanisms, Biomarkers, and Therapeutic Insights

Introduction: Severe acute pancreatitis (SAP) frequently results in complications like acute lung injury (ALI), which can substantially lead to adverse patient outcomes. Emerging research emphasizes the crucial role of microRNAs (miRNAs) in the mechanism underlying SAP-associated ALI. This systematic review aims to enhance the current understanding of miRNA-mediated processes and their utility as a target for therapy or biomarkers in SAP-ALI. Methods: We performed a comprehensive search across the PubMed and Google Scholar databases for studies exploring the role of miRNA in SAP-ALI, following PRISMA guidelines. We included preclinical and clinical investigations defining miRNA expression profiles, functional analyses, or therapeutic interventions. Relevant data on study design, miRNA targets, pathways involved, and outcomes were collected and analyzed. Results: A total of 11 studies were included, featuring animal models, patient-derived data, and cellular experiments. Findings indicated that certain miRNAs (such as miR-29a, miR-503-5p, miR-483-5p) are dysregulated in SAP-ALI, affecting inflammation, fibrosis, and altering immune response. miR-29a was associated with decreased fibroinflammatory responses, whereas miR-503-5p worsened the inflammatory response. The use of exosomes to deliver miRNA has demonstrated therapeutic potential in preclinical settings, with miRNAs like miR-181a-5p affecting key pathways, including the TLR4/NF-kB pathway. Studies based on patient data identified certain miRNAs (such as MiR-127, miR-1206b) as promising biomarkers for defining the severity and prognosis of SAP-ALI. Conclusion: This review highlights the important role of miRNAs in SAP-ALI pathogenesis and shows strong potential as both biomarkers and therapeutic targets. Future studies should focus on applying these findings to clinical settings to improve outcomes in SAP-ALI patients.