Narrative review discusses EV-associated non-coding RNAs in paediatric asthma

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Frontiers in Medicine Published May 7, 2026 Medically reviewed May 7, 2026 DOI ↗ By Dr. Julia Lee, PhD · Oncology, Genomics & Drug Development

Key Takeaway

Note limited direct evidence for EV-associated lncRNAs and circRNAs in paediatric airway remodelling.

This narrative review explores the potential involvement of extracellular vesicle-associated non-coding RNAs, including miRNAs, lncRNAs, and circRNAs, in the context of paediatric asthma. The scope of the review covers current literature regarding these molecular mechanisms within the disease state. The authors synthesize existing arguments to highlight the complexity of defining these vesicles in clinical research. A significant limitation identified is that most cited studies utilized operational EV terminology rather than biogenesis-specific exosomes because endosomal origin was not experimentally validated in most cases. This lack of experimental validation complicates the interpretation of findings related to specific vesicle types. Furthermore, direct evidence involving EV-associated lncRNAs and circRNAs in paediatric airway remodelling remains limited according to the authors. Consequently, the review does not provide definitive conclusions on clinical utility or safety profiles. The practice relevance is not explicitly defined, and no specific adverse events or tolerability data are reported. Clinicians should interpret these findings with caution given the current gaps in experimental validation and the limited direct evidence available for airway remodelling processes.

Study Details

Study typeSystematic review

EvidenceLevel 1

PublishedMay 2026

View Original Abstract ↓

Paediatric asthma is a chronic inflammatory airway disease that can cause airway swelling, excessive mucus secretion, and increased smooth muscle tone, leading to airway narrowing and respiratory distress. Airway remodelling involves a series of pathophysiological alterations, including airway epithelial injury, proliferation of mucous glands and goblet cells, subepithelial fibrosis, proliferation and migration of airway smooth muscle cells, and airway epithelial-mesenchymal transition. These complex processes significantly increase airway resistance and reactivity, forming a crucial pathological basis for refractory asthma. With advances in molecular biology, non-coding RNAs such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs) have garnered extensive attention due to their pivotal roles in gene expression regulation. Extracellular vesicles (EVs), as membrane-bound particles released by cells, can carry various bioactive molecules including non-coding RNAs, playing a crucial role in intercellular communication and influencing the functional state of recipient cells. In diseases such as asthma, non-coding RNAs participate in regulating processes including airway remodelling, emerging as potential diagnostic biomarkers and therapeutic targets. This narrative review summarises current evidence on EV-associated non-coding RNAs in paediatric asthma airway remodelling, noting that most cited studies used operational EV terminology rather than biogenesis-specific “exosomes” because endosomal origin was not experimentally validated in most cases. Current mechanistic evidence is strongest for miRNA-related studies, whereas direct evidence involving EV-associated lncRNAs and circRNAs in paediatric airway remodelling remains limited. The review therefore focuses on currently available mechanistic evidence, translational relevance, and major knowledge gaps.