Urinary miRNAs in bladder cancer

Urinary bladder cancer (UBC) is a prominent malignancy with high morbidity and mortality worldwide. Addressing this public health challenge requires the development of effective diagnostic and prognostic indicators. MicroRNAs (miRNAs) are short, non-coding sequences of nucleic acid that modulate gene expression. Due to their high stability in biofluids such as serum, blood and urine, they have become a viable source for noninvasive diagnosis of pathologic processes in general and UBC specifically. This review comprehensively explores the role of urinary miRNAs, both free and exosomal, in the diagnosis, progression, staging, grading, metastasis, recurrence, survival, and treatment of UBC that includes chemo and immunotherapy. Specific miRNAs such as miR-21, miR-126, miR-143, and miR-145 have shown potential as diagnostic markers, whereas others like miR200 family, miR-34a, miR-125b, and miR-221 are valuable for prognostic and predictive assessment. The review also discusses mechanistic insights into miRNA function and addresses the challenges of translating these findings into clinical practice. It aims to bridge the knowledge gap between academicians, researchers, and medical practitioners by providing a platform to understand, exchange, research, and infer information that could lead to novel therapeutic strategies for UBC. Integration of urinary miRNAs into routine clinical practice could significantly enhance the management of UBC, offering a pathway to personalized medicine and improved patient outcomes, particularly in India, where UBC incidence is increasing.