MicroRNA biomarkers in psoriasis.

Psoriasis, a T-helper mediated chronic inflammatory autoimmune skin disease, has significant socioeconomic burden worldwide. Unfortunately, etiology and underlying pathophysiology remains unclear. Although several biologics have substantially improved therapy, recurrence is common. The identification of reliable biomarkers for early diagnosis, prognosis, and therapeutic response remain significant challenges. Advances in omic technologies has enabled new approaches in biomarker discovery including microRNAs. These small non-coding RNA molecules that have emerged as promising biomarkers due to their regulatory roles in immune filtration, keratinocyte proliferation, apoptosis and inflammatory pathways in psoriasis. This review unites evidence on the prognostic and diagnostic potential of miRNAs in psoriasis and highlighting their altered expression profiles in psoriatic lesions and circulation. Specific miRNAs, such as miR-21, miR-31, miR-99a, miR-146a, miR-125b, and miR-203, miR-138, miR-155 in pathogenesis are explored as well as their association with disease severity, treatment response, and comorbidities. Furthermore, the integration of miRNA profiling with advanced omics technologies and machine learning provides a framework for developing predictive algorithms. The review consolidates the potential of miRNAs to guide personalized treatment strategies and their utility in monitoring therapeutic efficacy. Future research focusing on standardizing miRNA-based assays, integrating miRNA signatures with other omics approaches to enhance therapeutic outcomes and exploring their mechanistic roles may pave the way for their clinical translation as reliable biomarkers in management of disease.