{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:13:27Z","timestamp":1783653207514,"version":"3.55.0"},"reference-count":103,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Genet."],"abstract":"<jats:p>Nonalcoholic steatohepatitis (NASH), a significant advanced stage of nonalcoholic fatty liver disease (NAFLD), has become a focal point in contemporary liver disease research due to its intricate pathological characteristics and high prevalence. MicroRNAs (miRNAs), as pivotal regulators of gene expression, play pivotal roles in the pathophysiology of lipid metabolism disorders, inflammatory responses, apoptosis, and liver fibrosis during NASH progression. Despite recent preliminary insights into the functional roles of miRNAs in NASH, their specific mechanisms and clinical applications remain challenging. This systematic Frontiers in Immunology review examines miRNA expression patterns and the signaling pathways that regulate them, focusing on the diagnostic potential of circulating and exosomal miRNAs in NASH and the latest advances in miRNA-based therapeutic strategies. The objective of the present study is to integrate multi-omics and clinical research data to provide theoretical support and practical guidance for early diagnosis and precision treatment of NASH. 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