MicroRNA-451: A multifaceted regulator in cerebral and cardiac ischemia-reperfusion injury - from molecular mechanisms to therapeutic potential.

Ischemia-reperfusion injury (IRI) represents a major clinical challenge across various organ systems, with especially severe and often irreversible consequences in cardiac and cerebral tissues. Despite advances in understanding its pathophysiology, effective therapeutic strategies remain limited. MicroRNA-451 (miR-451), a highly conserved non-coding RNA located on human chromosome 17q11.2, has emerged as a critical regulator of key pathophysiological processes underlying IRI, including inflammation, immune cell function, oxidative stress, and programmed cell death. This review comprehensively examines the complex and sometimes paradoxical roles of miR-451 in cardiac and cerebral IRI. We explore miR-451's potential as both a diagnostic biomarker and therapeutic target in IRI management, highlighting innovative approaches such as exosome-mediated miR-451 delivery. Finally, we address critical challenges in translating miR-451-based therapies to clinical practice and outline promising directions for future research. This comprehensive analysis provides a theoretical framework for developing novel miR-451-focused strategies for IRI detection and treatment, with significant implications for improving outcomes in ischemic disorders.