Aug 2026· Current Issues in Molecular Biology· Vol 48· 0 citations· 278 references
Medicine
TL;DR
This comprehensive review examines the molecular architecture and mechanisms of established platforms in the clinical setting, including mRNA, antisense oligonucleotides (ASOs), small interfering RNAs (siRNAs) and aptamers, alongside next-generation platforms, such as CRISPR-guided systems and circular RNAs (circRNAs).
Abstract
RNA therapeutics have evolved from passive genetic intermediaries into highly programmable platforms, fundamentally transforming the landscape of precision medicine. This comprehensive review examines the molecular architecture and mechanisms of established platforms in the clinical setting, including mRNA, antisense oligonucleotides (ASOs), small interfering RNAs (siRNAs) and aptamers, alongside next-generation platforms, such as CRISPR-guided systems and circular RNAs (circRNAs). Moreover, we discuss strategies to overcome systemic delivery bottlenecks and evaluate advanced non-viral systems, emphasizing lipid nanoparticles (LNPs), polymers and tissue-specific ligand conjugates that facilitate precise intracellular targeting. Furthermore, we explore the clinical expansion of these platforms across infectious diseases, rare genetic disorders, oncology and cardiovascular conditions. Finally, we highlight how the integration of artificial intelligence (AI) and machine learning (ML) redefines the limits of individualized, programmable RNA therapies by accelerating sequence optimization and nanoparticle formulation.
This review argues that circular topology should be viewed as an active pharmacologic variable, not merely a stability enhancement, and dissect recent advances in cap-independent translation initiation, including IRES elements and m6A-driven mechanisms, rolling-circle translation for multi-epitope vaccine design, and p...
Amr A. El-Sehrawy, H. Al-Ameer, J. Rizaev et al.· Biotechnology and Bioenginee...· 0 citations
How CRISPR-enabled functional genomics approaches can reveal unexpected cancer dependencies and resistance mechanisms is outlined, and emerging applications of CRISPR-based diagnostics in oncology that convert precise nucleic acid sequence recognition into rapid mutation detection are discussed.
S. Grigg, Carolyn Shembrey, M. Fareh et al.· Nature Reviews Clinical Onco...· 1 citation
RNA therapeutics are a quickly developing discipline with enormous promise to improve precision medicine and offer efficient treatment choices for illnesses that are still challenging to treat with traditional medicines.
Shouvik Mondal, Nilufar Akhtar· International Journal of Lea...· 0 citations
The integration of computational prediction with programmable genome and RNA engineering may support more precise, adaptable, and clinically translatable mRNA therapeutics.
Haixing Shi, Shengbin Liu, Dan-Ling Dai et al.· MedComm – Biomaterials and A...· 0 citations
A comprehensive overview of the chemical biology and chemical modifications inherent to the design of robust siRNA therapies; the nucleic acid structure–function relationships that dictate the cellular mechanisms underlying siRNA-mediated gene silencing and efficacy; and the current clinical landscape and safety of app...
Hayden Tobias, Sarah Porter, Isabella M Marcelo et al.· RSC Chemical Biology· 0 citations
Pediatric gene therapy holds transformative potential to provide curative solutions for children, and the establishment of standardized regulatory frameworks, accompanied by robust and transparent AI integration, will be essential to ensure safe, equitable, and scalable translation.
Yinping Pan, Jian Ding, Wenhai Wang et al.· Pediatric Research· 0 citations
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