Non-coding RNAs in alcohol-associated liver disease.

Non-coding RNAs (ncRNAs), encompassing microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), have emerged as critical regulators of gene expression and cellular function. In alcohol-associated liver disease (ALD), chronic alcohol consumption disrupts the expression and function of ncRNAs in the liver and circulation, contributing to the disease's pathogenesis and progression. Dysregulated ncRNAs influence key pathways involved in hepatocyte injury, lipid metabolism, inflammation, and hepatic stellate cell (HSC) activation, thereby exacerbating steatosis, inflammation, and fibrosis. Furthermore, extracellular vesicles play a pivotal role in mediating ncRNA-driven intercellular communication, amplifying liver damage and fibrosis. This review provides a comprehensive overview of the multifaceted roles of ncRNAs in ALD, with a focus on their mechanistic contributions to disease development and progression. Additionally, we discuss the potential of ncRNAs as diagnostic biomarkers and therapeutic targets, emphasizing their translational relevance in addressing the burden of ALD.