MICRORNA-BASED DELIVERY SYSTEMS: A SYSTEMATIC REVIEW OF THERAPEUTIC STRATEGIES FOR CHRONIC PAIN MANAGEMENT

Abstract

Chronic pain remains a significant clinical challenge, with conventional therapies often providing limited efficacy or undesirable side effects, hence driving the exploration of novel therapeutic strategies such as microRNA (miRNA)-based delivery systems. This systematic review synthesizes current evidence on the role of miRNAs in chronic pain management, focusing on their diagnostic potential, therapeutic applications, and underlying mechanisms. We critically evaluate the dual utility of miRNAs as biomarkers for pain diagnosis and as therapeutic agents, emphasizing their ability to modulate pain pathways through targeted gene regulation. The review identifies key miRNA candidates implicated in pain pathophysiology, then discusses their delivery systems, including viral vectors, lipid nanoparticles, and exosomes, which enhance stability and tissue specificity. By analyzing preclinical and clinical studies, we highlight the translational potential of miRNA-based therapies while addressing challenges such as off-target effects and delivery efficiency. Our findings suggest that miRNA-based interventions hold promise for personalized pain management, yet further research is needed to optimize their safety and efficacy. The review also delineates boundaries by excluding non-miRNA-related pain research and studies focused on other diseases, ensuring a focused analysis. Collectively, this work provides a comprehensive framework for understanding miRNA-based delivery systems in chronic pain, offering insights into future directions for both basic and clinical research.