{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T09:05:19Z","timestamp":1784019919756,"version":"3.55.0"},"reference-count":83,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Carotid atherosclerosis is a major contributor to ischemic stroke, driven by complex interactions between inflammation, lipid metabolism, and vascular dysfunction. MicroRNAs (miRNAs) have emerged as key regulators of the molecular mechanisms underlying plaque formation, progression, and instability. This review summarizes current evidence on the role of miRNAs in endothelial dysfunction, vascular smooth muscle cell proliferation, macrophage activation, and plaque vulnerability. Specific miRNAs, including miR-21, miR-145, and miR-200c, demonstrate context-dependent effects on atherogenic and protective pathways. Circulating miRNA profiles show strong potential as noninvasive biomarkers for assessing plaque instability and predicting cardiovascular ischemic events, and as promising therapeutic targets. Despite these advances, challenges remain in standardization and clinical implementation. Integration of multi-miRNA panels with imaging modalities, conventional biomarkers, and emerging artificial intelligence approaches may improve risk stratification and support personalized management of carotid artery disease.<\/jats:p>","DOI":"10.3390\/biom16071026","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T08:04:31Z","timestamp":1784016271000},"page":"1026","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["MicroRNA Profiling of the Pathophysiological Mechanisms Underlying Carotid Atherosclerosis Progression"],"prefix":"10.3390","volume":"16","author":[{"given":"Katarzyna","family":"Prus","sequence":"first","affiliation":[{"name":"Department of Stroke and Early Post-stroke Rehabilitation, University Clinical Hospital No. 4, 20-090 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7555-4872","authenticated-orcid":false,"given":"Marco","family":"Sanvitti","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, \u201cSapienza\u201d University of Rome, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-6646","authenticated-orcid":false,"given":"Federico","family":"Bilotta","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Intensive Care and Pain Medicine, University of Tor Vergata, 00133 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1161\/01.STR.0000152336.71224.21","article-title":"Carotid Plaque Pathology: Thrombosis, Ulceation, and Stroke Pathogenesis","volume":"36","author":"Fisher","year":"2005","journal-title":"Stroke"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"127","DOI":"10.4103\/bc.bc_36_22","article-title":"Carotid Atherosclerotic Disease: A Systematic Review of Pathogenesis and Management","volume":"8","author":"Bir","year":"2022","journal-title":"Brain Circ."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bargie\u0142, W., Cierpiszewska, K., Maruszczak, K., Paku\u0142a, A., Szwankowska, D., Wrzesi\u0144ska, A., Gutowski, \u0141., and Formanowicz, D. 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