Unraveling the role of miRNAs in placental function: insights into trophoblast biology and pregnancy pathology.

MicroRNAs (miRNAs) are pivotal regulators of placental development and function, orchestrating critical processes such as trophoblast proliferation, differentiation, invasion, and vascular remodeling. By modulating diverse signaling pathways, these small non-coding RNAs help ensure proper placental formation and optimal maternal-fetal nutrients and gases exchange. Dysregulated miRNA expressions can profoundly affect placental biology, leading to complications such as preeclampsia, fetal growth restriction, and recurrent pregnancy loss. Accumulating evidence implicates abnormal miRNA profiles in defective spiral artery remodeling and impaired trophoblast activity. Notably, circulating miRNAs exhibit high stability and tissue specificity, positioning them as promising noninvasive biomarkers for early detection of pregnancy complications. Recent preclinical studies highlight the therapeutic potential of miRNA-based modulators using mimics or inhibitors to restore normal placental function. However, challenges remain in optimizing placental-targeted delivery systems. Collectively, miRNAs are pivotal in placental health and disease, offering potential as biomarkers and therapeutic targets.