Molecular Mechanism and Application Progress of Circular RNA Regulating Ischemic Stroke Through the Competing Endogenous RNA Network

Tianpei WANG, Lili TENG, Minmin WU, Wenjing SONG, Hanwen MA, Luwen ZHU

Acta Academiae Medicinae Sinicae ›› 2026, Vol. 48 ›› Issue (1) : 144-152.

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Acta Academiae Medicinae Sinicae

Abbreviation (ISO4): Acta Academiae Medicinae Sinicae      Editor in chief: Xuetao CAO

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Acta Academiae Medicinae Sinicae ›› 2026, Vol. 48 ›› Issue (1) : 144-152. DOI: 10.3881/j.issn.1000-503X.16778
Review Articles

Molecular Mechanism and Application Progress of Circular RNA Regulating Ischemic Stroke Through the Competing Endogenous RNA Network

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Abstract

Ischemic stroke(IS)remains a predominant contributor to mortality and disability,with current clinical interventions demonstrating suboptimal therapeutic efficacy.Recent studies have shown that circular RNA(circRNA)participates in pathological processes through the competing endogenous RNA(ceRNA)regulatory network,involving key processes such as apoptosis,inflammatory response,angiogenesis,autophagy,oxidative stress,and neuronal regeneration.This study reviews the molecular mechanism and application progress of circRNA regulating IS through the ceRNA network,aiming to provide theoretical support for the in-depth development of circRNA in the diagnosis and treatment strategies of IS and offer guidance for future related research and clinical practice.

Key words

circular RNA / ischemic stroke / molecular mechanism / biomarker / targeted therapy

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Tianpei WANG , Lili TENG , Minmin WU , et al . Molecular Mechanism and Application Progress of Circular RNA Regulating Ischemic Stroke Through the Competing Endogenous RNA Network[J]. Acta Academiae Medicinae Sinicae. 2026, 48(1): 144-152 https://doi.org/10.3881/j.issn.1000-503X.16778

References

[1]
Owolabi MO, Thrift AG, Mahal A, et al. Primary stroke prevention worldwide:translating evidence into action[J]. Lancet Public Health, 2022, 7(1):e74-e85.DOI:10.1016/S2468-2667(21)00230-9.
[2]
Avan A, Digaleh H, Di Napoli M, et al. Socioeconomic status and stroke incidence,prevalence,mortality,and worldwide burden:an ecological analysis from the Global Burden of Disease Study 2017[J]. BMC Med, 2019, 17(1):191.DOI:10.1186/s12916-019-1397-3.
[3]
Salmena L, Poliseno L, Tay Y, et al. A ceRNA hypothesis:the Rosetta Stone of a hidden RNA language[J]. Cell, 2011, 146(3):353-358.DOI:10.1016/j.cell.2011.07.014.
[4]
Hansen TB, Jensen TI, Clausen BH, et al. Natural RNA circles function as efficient microRNA sponges[J]. Nature, 2013, 495(7441):384-388.DOI:10.1038/nature11993.
[5]
Qu X, Li Z, Chen J, et al. The emerging roles of circular RNAs in CNS injuries[J]. J Neurosci Res, 2020, 98(7):1485-1497.DOI:10.1002/jnr.24591.
[6]
Ren S, Lin P, Wang J, et al. Circular RNAs:promising molecular biomarkers of human aging-related diseases via functioning as an miRNA sponge[J]. Mol Ther Methods Clin Dev, 2020, 18:215-229.DOI:10.1016/j.omtm.2020.05.027.
[7]
Jeck WR, Sorrentino JA, Wang K, et al. Circular RNAs are abundant,conserved,and ssociated with ALU repeats[J]. RNA, 2013, 19(2):141-157.DOI:10.1261/rna.035667.112.
[8]
Chu LY, Hsieh TJ, Golzarroshan B, et al. Structural insights into RNA unwinding and degradation by RNase R[J]. Nucleic Acids Res, 2017, 45(20):12015-12024.DOI:10.1093/nar/gkx880.
[9]
Wang C, Tan S, Li J, et al. CircRNAs in lung cancer-Biogenesis,function and clinical implication[J]. Cancer Lett, 2020, 492:106-115.DOI:10.1016/j.canlet.2020.08.013.
[10]
Kristensen LS, Andersen MS, Stagsted LVW, et al. The biogenesis,biology and characterization of circular RNAs[J]. Nat Rev Genet, 2019, 20(11):675-691.DOI:10.1038/s41576-019-0158-7.
[11]
Zhang M, Xin Y. Circular RNAs:a new frontier for cancer diagnosis and therapy[J]. J Hematol Oncol, 2018, 11(1):21.DOI:10.1186/s13045-018-0569-5.
[12]
Piwecka M, Glažar P, Hernandez-Miranda LR, et al. Loss of a mammalian circular RNA locus causes miRNA deregulation and affects brain function[J]. Science, 2017, 357(6357):eaam8526.DOI:10.1126/science.aam8526.
[13]
Zhang XO, Wang HB, Zhang Y, et al. Complementary sequence-mediated exon circularization[J]. Cell, 2014, 159(1):134-147.DOI:10.1016/j.cell.2014.09.001.
[14]
Li Z, Huang C, Bao C, et al. Exon-intron circular RNAs regulate transcription in the nucleus[J]. Nat Struct Mol Biol, 2015, 22(3):256-264.DOI:10.1038/nsmb.2959.
[15]
Chen XL, Tan QD, Chen KJ, et al. CircRNA and stroke:new insight of potential biomarkers and therapeutic targets[J]. Neurochem Res, 2024, 49(3):557-567.DOI:10.1007/s11064-023-04077-6.
[16]
Sakshi S, Jayasuriya R, Ganesan K, et al. Role of circRNA-miRNA-mRNA interaction network in diabetes and its associated complications[J]. Mol Ther Nucleic Acids, 2021, 26:1291-1302.DOI:10.1016/j.omtn.2021.11.007.
[17]
Cao S, Zeng Y, Chen M, et al. Integrated analysis of immune-related circRNA-miRNA-mRNA regulatory network in ischemic stroke[J]. Front Neurol, 2022, 13:889855.DOI:10.3389/fneur.2022.889855.
[18]
Zhang K, Shan G, Chen L. Modulating miRNA binding sites within circRNA for enhanced translation efficiency[J]. Justc, 2023, 53(9):904-913.DOI:10.52396/JUSTC-2023-0048.
[19]
Xu G, Liu G, Wang Z, et al. Circular RNAs:promising treatment targets and biomarkers of ischemic stroke[J]. Int J Mol Sci, 2023, 25(1):178.DOI:10.3390/ijms25010178.
[20]
Constantin L. Circular RNAs and neuronal development[M]// Xiao J. Circular RNAs: Vol.1087.Singapore:Springer Singapore, 2018:205-213.
[21]
Ye J, Shan Y, Zhou X, et al. Identification of novel circular RNA targets in key penumbra region of rats after cerebral ischemia-reperfusion injury[J]. J Mol Neurosci, 2023, 73(9-10):751-762.DOI:10.1007/s12031-023-02153-8.
[22]
Li Y, Zhao J, Yu S, et al. Extracellular vesicles long RNA sequencing reveals abundant mRNA,circRNA,and lncRNA in human blood as potential biomarkers for cancer diagnosis[J]. Clin Chem, 2019, 65(6):798-808.DOI:10.1373/clinchem.2018.301291.
[23]
Jiang H, He P, Chen S, et al. Identification of a circRNA-mediated immune-related ceRNA network and circRNAs as diagnostic biomarkers in acute ischemic stroke[J]. Eur J Med Res, 2025, 30(1):114.DOI:10.1186/s40001-025-02356-2.
[24]
He W, Cheng Y, Lai Y. CircRNA_102046 affects the occurrence and development of ischemic stroke by regulating the miR-493-5p/ROCK1 signaling[J]. Cardiovasc Toxicol, 2024, 24(3):280-290.DOI:10.1007/s12012-024-09831-y.
[25]
Kawamoto Y, Nakajima YI, Kuranaga E. Apoptosis in cellular society:communication between apoptotic cells and their neighbors[J]. Int J Mol Sci, 2016, 17(12):2144.DOI:10.3390/ijms17122144.
[26]
Broughton BRS, Reutens DC, Sobey CG. Apoptotic mechanisms after cerebral ischemia[J]. Stroke, 2009, 40(5):e331-e339.DOI:10.1161/STROKEAHA.108.531632.
[27]
Chen G, Shan X, Li L, et al. circHIPK3 regulates apoptosis and mitochondrial dysfunction induced by ischemic stroke in mice by sponging miR-148b-3p via CDK5R1/SIRT1[J]. Exp Neurol, 2022, 355:114115.DOI:10.1016/j.expneurol.2022.114115.
[28]
Chen W, Wang H, Zhu Z, et al. Exosome-shuttled circSHOC2 from IPASs regulates neuronal autophagy and ameliorates ischemic brain injury via the miR-7670-3p/SIRT1 axis[J]. Mol Ther Nucleic Acids, 2020, 22:657-672.DOI:10.1016/j.omtn.2020.09.027.
[29]
Xue LX, Chen SF, Xue SX, et al. LncRNA TUG1 compromised neuronal mitophagy in cerebral ischemia/reperfusion injury by targeting sirtuin 1[J]. Cell Biol Toxicol, 2022, 38(6):1121-1136.DOI:10.1007/s10565-022-09700-w.
[30]
Wang K, Gan TY, Li N, et al. Circular RNA mediates cardiomyocyte death via miRNA-dependent upregulation of MTP18 expression[J]. Cell Death Differ, 2017, 24(6):1111-1120.DOI:10.1038/cdd.2017.61.
[31]
Jayaraj RL, Azimullah S, Beiram R, et al. Neuroinflammation:friend and foe for ischemic stroke[J]. J Neuroinflammation, 2019, 16(1):142.DOI:10.1186/s12974-019-1516-2.
[32]
Bai Y, Zhang Y, Han B, et al. Circular RNA DLGAP4 ameliorates ischemic stroke outcomes by targeting miR-143 to regulate endothelial-mesenchymal transition associated with blood-brain barrier integrity[J]. J Neurosci, 2018, 38(1):32-50.DOI:10.1523/JNEUROSCI.1348-17.2017.
[33]
Qiu L, He J, Chen H, et al. CircDLGAP4 overexpression relieves oxygen-glucose deprivation-induced neuronal injury by elevating NEGR1 through sponging miR-503-3p[J]. J Mol Histol, 2022, 53(2):321-332.DOI:10.1007/s10735-021-10036-8.
[34]
Tian DS, Qin C, Zhou LQ, et al. FSAP aggravated endothelial dysfunction and neurological deficits in acute ischemic stroke due to large vessel occlusion[J]. Signal Transduct Target Ther, 2022, 7(1):6.DOI:10.1038/s41392-021-00802-1.
[35]
Li Y, Liu XT, Zhang PL, et al. Hydroxysafflor yellow a blocks HIF-1α induction of NOX2 and protects ZO-1 protein in cerebral microvascular endothelium[J]. Antioxidants(Basel), 2022, 11(4):728.DOI:10.3390/antiox11040728.
[36]
Li J, Wang J, Wang Z. Circ_0006768 upregulation attenuates oxygen-glucose deprivation/reoxygenation-induced human brain microvascular endothelial cell injuries by upregulating VEZF1 via miR-222-3p inhibition[J]. Metab Brain Dis, 2021, 36(8):2521-2534.DOI:10.1007/s11011-021-00775-8.
[37]
Yang X, Li X, Zhong C, et al. Circular RNA circPHKA2 relieves OGD-induced human brain microvascular endothelial cell injuries through competitively binding miR-574-5p to modulate SOD2[J]. Oxid Med Cell Longev, 2021, 2021:3823122.DOI:10.1155/2021/3823122.
[38]
Wang HG, Yan H, Wang C, et al. circAFF1 aggravates vascular endothelial cell dysfunction mediated by miR-516b/SAV1/YAP1 axis[J]. Front Physiol, 2020, 11:899.DOI:10.3389/fphys.2020.00899.
[39]
Gao HM, Chen H, Cui GY, et al. Damage mechanism and therapy progress of the blood-brain barrier after ischemic stroke[J]. Cell Biosci, 2023, 13(1):196.DOI:10.1186/s13578-023-01126-z.
[40]
郑继青, 龙耀斌, 刘云. CircRNA作用于急性缺血性脑卒中的研究进展[J]. 天津医药, 2022, 50(12):1335-1339.DOI:10.11958/20220671.
[41]
Zhang Y, Yuan X, Xu J, et al. CircRBM33 induces endothelial dysfunction by targeting the miR-6838-5p/PDCD4 axis affecting blood-brain barrier in mice with cerebral ischemia-reperfusion injury[J]. Clin Hemorheol Microcirc, 2023, 85(4):355-370.DOI:10.3233/CH-231776.
[42]
Yang R, Chen J, Xu B, et al. circ_2858 helps blood-brain barrier disruption by increasing VEGFA via sponging miR-93-5p during escherichia coli meningitis[J]. Mol Ther Nucleic Acids, 2020, 22:708-721.DOI:10.1016/j.omtn.2020.09.034.
[43]
Zhang Y, Cao Y, Liu C. Autophagy and ischemic stroke[J]. Adv Exp Med Biol, 2020, 1207:111-134.DOI:10.1007/978-981-15-4272-5_7.
[44]
Zhou D, Huang Z, Zhu X, et al. Circular RNA 0025984 ameliorates ischemic stroke injury and protects astrocytes through miR-143-3p/TET1/ORP150 pathway[J]. Mol Neurobiol, 2021, 58(11):5937-5953.DOI:10.1007/s12035-021-02486-8.
[45]
Yu H, Pan Y, Dai M, et al. Circ_0003423 alleviates ox-LDL-induced human brain microvascular endothelial cell injury via the miR-589-5p/TET2 network[J]. Neurochem Res, 2021, 46(11):2885-2896.DOI:10.1007/s11064-021-03387-x.
[46]
Han B, Zhang Y, Zhang Y, et al. Novel insight into circular RNA HECTD1 in astrocyte activation via autophagy by targeting MIR142-TIPARP:implications for cerebral ischemic stroke[J]. Autophagy, 2018, 14(7):1164-1184.DOI:10.1080/15548627.2018.1458173.
[47]
Zhao X, Moore DL. Neural stem cells:developmental mechanisms and disease modeling[J]. Cell Tissue Res, 2018, 371(1):1-6.DOI:10.1007/s00441-017-2738-1.
[48]
Gage FH, Temple S. Neural stem cells:generating and regenerating the brain[J]. Neuron, 2013, 80(3):588-601.DOI:10.1016/j.neuron.2013.10.037.
[49]
Yang B, Zang L, Cui J, et al. Circular RNA TTC3 regulates cerebral ischemia-reperfusion injury and neural stem cells by miR-372-3p/TLR4 axis in cerebral infarction[J]. Stem Cell Res Ther, 2021, 12(1):125.DOI:10.1186/s13287-021-02187-y.
[50]
Anaya-Fernández R, Anaya-Prado R, Anaya-Fernandez MM, et al. Oxidative stress in cerebral ischemia/reperfusion injury[J]. OBM Neurobiol, 2024, 8(3):1-15.DOI:10.21926/obm.neurobiol.2403239.
[51]
Zuo L, Zhang L, Zu J, et al. Circulating circular RNAs as biomarkers for the diagnosis and prediction of outcomes in acute ischemic stroke[J]. Stroke, 2020, 51(1):319-323.DOI:10.1161/STROKEAHA.119.027348.
[52]
Mei Z, Huang L, Rao W. CircNUFIP2 overexpression induces GDF11 to ameliorate oxygen-glucose deprivation-induced hippocampal neuron cell apoptosis and oxidative stress after cerebral ischemia[J]. Neurol Res, 2023, 45(1):70-80.DOI:10.1080/01616412.2022.2123172.
[53]
Xu X, Wu Z, Qiu H, et al. Circular RNA circPHC3 promotes cell death and apoptosis in human BMECs after oxygen glucose deprivation via miR-455-5p/TRAF3 axis in vitro[J]. Neuropsychiatr Dis Treat, 2021, 17:147-156.DOI:10.2147/NDT.S288669.
[54]
He GH, Wang Z, Xu W, et al. Knockdown of circHECTD1 inhibits oxygen-glucose deprivation and reperfusion induced endothelial-mesenchymal transition[J]. Metab Brain Dis, 2022, 37(2):427-437.DOI:10.1007/s11011-021-00891-5.
[55]
Zhang Y, Zhang XO. Unveiling circRNA-mediated ceRNA networks in ischemic stroke by integrative analysis of multi-source gene expression profiling[J]. Heliyon, 2024, 10(17):e36988.DOI:10.1016/j.heliyon.2024.e36988.
[56]
Lu D, Ho ES, Mai H, et al. Identification of blood circular RNAs as potential biomarkers for acute ischemic stroke[J]. Front Neurosci, 2020, 14:81.DOI:10.3389/fnins.2020.00081.
[57]
Wang X, Zhang S, Zhang Z, et al. Increased plasma levels of circPTP4A2 and circTLK2 are associated with stroke injury[J]. Ann Clin Transl Neurol, 2023, 10(8):1481-1492.DOI:10.1002/acn3.51837.
[58]
Yang L, Han B, Zhang Z, et al. Extracellular vesicle-mediated delivery of circular RNA SCMH1 promotes functional recovery in rodent and nonhuman primate ischemic stroke models[J]. Circulation, 2020, 142(6):556-574.DOI:10.1161/CIRCULATIONAHA.120.045765.
[59]
Zhang Z, Ma B, Li B, et al. Cardiolipin-mimic lipid nanoparticles without antibody modification delivered senolytic in-vivo CAR-T therapy for inflamm-aging[J]. Cell Rep Med, 2025, 6(7):102209.DOI:10.1016/j.xcrm.2025.102209.
[60]
Xu S, Xu Y, Solek NC, et al. Tumor-tailored ionizable lipid nanoparticles facilitate IL-12 circular RNA delivery for enhanced lung cancer immunotherapy[J]. Adv Mater, 2024, 36(29):e2400307.DOI:10.1002/adma.202400307.
[61]
Unti MJ, Jaffrey SR. Highly efficient cellular expression of circular mRNA enables prolonged protein expression[J]. Cell Chem Biol, 2024, 31(1):163-176.e5.DOI:10.1016/j.chembiol.2023.09.015.
[62]
Cao X, Cai Z, Zhang J, et al. Engineering circular RNA medicines[J]. Nat Rev Bioeng, 2024, 2(1):1-18.DOI:10.1038/s44222-024-00259-1.
[63]
Liu C, Yao MD, Li CP, et al. Silencing of circular RNA-ZNF609 ameliorates vascular endothelial dysfunction[J]. Theranostics, 2017, 7(11):2863-2877.DOI:10.7150/thno.19353.
[64]
Yang Z, Huang C, Wen X, et al. Circular RNA circ-FoxO3 attenuates blood-brain barrier damage by inducing autophagy during ischemia/reperfusion[J]. Mol Ther, 2022, 30(3):1275-1287.DOI:10.1016/j.ymthe.2021.11.004.
[65]
Wu F, Han B, Wu S, et al. Circular RNA TLK1 aggravates neuronal injury and neurological deficits after ischemic stroke via miR-335-3p/TIPARP[J]. J Neurosci, 2019, 39(37):7369-7393.DOI:10.1523/JNEUROSCI.0299-19.2019.
[66]
Vromman M, Vandesompele J, Volders PJ. Closing the circle:current state and perspectives of circular RNA databases[J]. Brief Bioinform, 2020, 22(1):288-297.DOI:10.1093/bib/bbz175.
[67]
Zhou Z, Han B, Wang Y, et al. Fast and sensitive multivalent spatial pattern-recognition for circular RNA detection[J]. Nat Commun, 2024, 15(1):10900.DOI:10.1038/s41467-024-55364-x.

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