MicroRNA-181a in acute lymphoblastic leukemia: expression pattern, target genes and its potential as a biomarker.

The exact etiology of Acute Lymphoblastic Leukemia (ALL) is not yet fully understood. Inherited genetic abnormalities and exposure to environmental risk factors are implicated in pathogenesis of ALL patients. Over the past two decades, epigenetic factors like microRNAs (miRs) have been in the spotlight and shown to have a pivotal role in the pathogenicity of ALL. MiRs are a group of small non-coding single-stranded RNAs (∼22 nucleotides) involved in post-transcriptional regulation of gene expression. MiR-181a has been shown to have a dual behavior in different types of cancers. This dual behavior of miR-181a shows that it should be investigated in a disease-specific manner. In this study, 24 studies were reviewed in different sections including the expression pattern of miR-181a, its target genes, and its potential as a biomarker in ALL from January 2000 to March 2025. Results of the reviewed studies conclusively indicate that miR-181a-5p is upregulated in pediatric ALL patients compared to normal control groups, and miR-181a-5p acts as an oncomir in pediatric ALL patients. Nevertheless, there are only a few studies in adults with inconclusive results. Furthermore, miR-181a-5p might be the upstream activator of the leukemic T-cell proliferation by having direct and indirect effects on several genes. Recent studies indicate that this miR can be implemented in diagnosing and classifying central nervous system (CNS) involvement in ALL patients, which is a devastating challenge in the field of hematology-oncology.