Research progresses on the regulatory roles of microRNAs in radiation-induced pulmonary fibrosis.

Radiation-induced pulmonary fibrosis (RIPF) is a chronic fibrotic lung disease triggered by ionizing radiation exposure and is characterized by abnormal epithelial-mesenchymal transition (EMT), fibroblast proliferation and activation, and excessive extracellular matrix (ECM) deposition. As a late-stage pulmonary complication of radiation exposure, RIPF lacks effective clinical interventions. Although nintedanib and pirfenidone are approved antifibrotic drugs for idiopathic pulmonary fibrosis (IPF), their efficacy against RIPF remains insufficiently validated. The precise pathogenesis of RIPF remains incompletely understood; however, accumulating evidence highlights the critical regulatory role of epigenetic modifications, particularly microRNAs (miRNAs), in the development and progression of RIPF. Here, we summarize the regulatory mechanisms of miRNAs in RIPF, and highlight their clinical potential and current research challenges, aiming to advance miRNA-related research in RIPF.