He YN, Zhu HH, Zhou ZH, Qu KK. Exosomal microRNAs in common mental disorders: Mechanisms, biomarker potential and therapeutic implications. World J Psychiatry 2025; 15(8): 108933 [DOI: 10.5498/wjp.v15.i8.108933]
Corresponding Author of This Article
Kan-Kan Qu, MD, Doctor, Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, No. 156 Qianrong Road, Binhu District, Wuxi 214151, Jiangsu Province, China. qukankan87@126.com
Research Domain of This Article
Psychiatry
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Psychiatry. Aug 19, 2025; 15(8): 108933 Published online Aug 19, 2025. doi: 10.5498/wjp.v15.i8.108933
Exosomal microRNAs in common mental disorders: Mechanisms, biomarker potential and therapeutic implications
Ya-Nan He, Hao-Hao Zhu, Zhen-He Zhou, Kan-Kan Qu
Ya-Nan He, Zhen-He Zhou, Department of Psychiatry, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China
Hao-Hao Zhu, Kan-Kan Qu, Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, Wuxi 214151, Jiangsu Province, China
Co-corresponding authors: Zhen-He Zhou and Kan-Kan Qu.
Author contributions: Zhou ZH provided financial support and approved the final version; Qu KK designed the review framework and performed critical appraisal of selected studies; He YN conducted the systematic literature search and drafted the manuscript; Zhu HH supervised the research and revised the intellectual structure; All authors approved the final submission.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kan-Kan Qu, MD, Doctor, Department of Pharmacy, The Affiliated Mental Health Center of Jiangnan University, No. 156 Qianrong Road, Binhu District, Wuxi 214151, Jiangsu Province, China. qukankan87@126.com
Received: April 27, 2025 Revised: June 3, 2025 Accepted: June 24, 2025 Published online: August 19, 2025 Processing time: 104 Days and 22.1 Hours
Abstract
To illustrate the mechanisms of exosomal microRNAs (miRNAs) in common mental disorders, and explore their potential as diagnostic biomarkers and therapeutic targets, a systematic literature review of relevant studies on exosomal miRNAs in mental disorders was conducted. Data from cell experiments, animal models, and clinical studies were analyzed and combined to study the mechanisms and roles of exosomal miRNAs in various mental disorders. Research has shown that exosomal miRNAs, such as miR-146a, miR-223, miR-125b, and miR-451a, affect Alzheimer’s disease (AD) formation by regulating key pathways such as toll-like receptor 4 (TLR4) and phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt), respectively. MiR-146a-5p regulates the occurrence of schizophrenia through the Notch pathway. TLR4 regulates miR-146a and miR-155 in major depressive disorder (MDD), and miR-144-5p regulates the disease through PI3K/Akt. Exosomal miR-484, miR-652-3p, miR-142-3p, miR-21a-3p, and miR-21-5p regulate key pathways in bipolar disorder, autism spectrum disorder, and Rett syndrome (e.g., TLR4, PI3K/Akt, and Epha4/TEK) and have an influence on mental disorders. Exosomal miRNAs are involved in the occurrence of mental disorders through TLR4, PI3K/Akt, and Epha4/TEK pathways, which provides a clearer understanding of disease cognition. Of these pathways, the TLR4 and PI3K/Akt pathways play a role in AD, MDD, and neurodevelopmental disorders, which can be used as an effective breakthrough in the study of mental disorders. Exosomal miRNAs could also serve as diagnostic biomarkers and therapeutic targets, providing new insights into precise interventions for mental disorders.
Core Tip: This synthesis highlights exosomal microRNAs as dual-functional tools bridging mechanistic insights into mental disorders and paving the way for personalized diagnostics/therapeutics. Focus on shared pathways (e.g., toll-like receptor 4, phosphatidylinositol 3-kinase/protein kinase B) may unify treatment strategies across diverse psychiatric conditions.
