MicroRNAs as Diagnostic Biomarkers of Myasthenia Gravis: A Systematic Review and Meta-Analysis.

Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fluctuating muscle weakness. MicroRNAs (miRNAs) have emerged as potential biomarkers for MG diagnosis, offering noninvasive and reliable detection. This systematic review and meta-analysis evaluated the diagnostic accuracy of miRNAs in MG. A comprehensive search of PubMed, Embase, and Google Scholar was conducted up to March 9, 2025. Eligible studies assessing miRNAs as MG biomarkers were selected on the basis of predefined criteria. Pooled sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated via random effects model. Heterogeneity was assessed via I², and publication bias was evaluated via Deeks' funnel plot. Nine studies including 1,797 participants were analysed. The pooled sensitivity and specificity were 0.80 (95% CI: 0.75-0.84) and 0.71 (95% CI: 0.65-0.77), respectively, with an area under the curve (AUC) of 0.83. Bivariate heterogeneity analysis indicated moderate variability, the cause of which were identified using subgroup analysis with region, clinical subtypes and seropositivity as subgroups. miRNAs demonstrate strong diagnostic potential for MG, with good sensitivity and specificity. However, standardized methodologies and further validation in large, multicentre studies is warranted.