Macrophage microRNAs integrating lipid metabolism and inflammation: Implications for atherosclerosis

Atherosclerosis (AS) is the primary pathological basis of global cardiovascular diseases. Its progression is a complex process driven by the dynamic interplay between lipid metabolism disorders and immune-inflammatory responses. Macrophages play a central role in this pathology, actively participating from early monocyte recruitment and differentiation to the formation of foam cells and the inflammation triggered by lipid accumulation. Dysfunctional macrophages are involved throughout the entire process of AS development. MicroRNAs (miRNAs) act as critical post-transcriptional regulators, modulating the intricate balance between lipid metabolism and inflammatory responses. MiRNAs contribute to lipid homeostasis by regulating key processes, including lipid uptake, cholesterol efflux, and fatty acid synthesis. Additionally, miRNAs modulate critical inflammatory signaling pathways and transcription factors, exacerbating immune responses and driving disease progression. This paper focuses specifically on macrophages, systematically reviewing the role of miRNAs as key mediators linking lipid metabolism and immune responses, and highlighting their core function and therapeutic potential in atherosclerosis.