{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T00:19:07Z","timestamp":1793751547531,"version":"4.6.1"},"reference-count":101,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T00:00:00Z","timestamp":1762214400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>Adenomyosis (AM) is a hormonally responsive uterine disorder defined by ectopic endometrial tissue within the myometrium, causing pain, abnormal bleeding, and subfertility. Non-coding RNAs (ncRNAs)\u2014including microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs)\u2014are post-transcriptional regulators implicated also in uterine remodeling. We systematically reviewed original studies evaluating ncRNAs in AM using human samples, in vitro and animal models, or bioinformatic approaches. Data sources included PubMed and Google Scholar (inception up to 10 August 2025). Forty-one studies were included and synthesized across mechanistic, diagnostic, and translational domains. miRNAs (n = 31) were the most studied subclass, followed by lncRNAs (n = 10) and circRNAs (n = 5). Recurrent miRNAs such as miR-10b and miR-30c-5p (downregulated, inhibitory) and miR-145 (upregulated, promotive) regulate epithelial invasion, epithelial\u2013mesenchymal transition, and cytoskeletal remodeling via PI3K\u2013AKT\/MAPK and Talin1 signaling. The let-7a\/LIN28B axis governed estrogen-sensitive proliferation in the junctional zone, while miR-21 exhibited compartment-specific roles in decidualization and ectopic cell survival. Extracellular-vesicle (EV)-bornemiRNAs (e.g., miR-92a-3p, miR-25-3p, miR-4669) contributed to immune polarization and show early diagnostic potential. lncRNAs and circRNAs acted via chromatin modifiers and ceRNA networks. Most findings remain at the discovery stage. Convergent dysregulation was observed in key signaling pathways, including JAK\u2013STAT, Wnt\/\u03b2-catenin, and Hippo\u2013YAP. ncRNAs regulate critical axes of invasion, proliferation, immune modulation, and hormonal response in AM. Targets with preliminary causal support\u2014miR-10b\/ZEB1, let-7a\/LIN28B, and miR-145\/Talin1\u2014warrant further validation. Circulating miRNAs\u2014especially in EVs\u2014offer promise for non-invasive diagnosis.<\/jats:p>","DOI":"10.3390\/ijms262110713","type":"journal-article","created":{"date-parts":[[2025,11,4]],"date-time":"2025-11-04T11:11:16Z","timestamp":1762254676000},"page":"10713","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Non-Coding RNAs (microRNAs, lncRNAs, circRNAs) in Adenomyosis: A Systematic Review of Mechanistic and Translational Evidence"],"prefix":"10.3390","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6828-1887","authenticated-orcid":false,"given":"Rafa\u0142","family":"Watrowski","sequence":"first","affiliation":[{"name":"Department of Gynecology, Helios Hospital M\u00fcllheim, Teaching Hospital of the University of Freiburg, Heliosweg 1, 79379 M\u00fcllheim, Germany"},{"name":"Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5279-3095","authenticated-orcid":false,"given":"Stoyan","family":"Kostov","sequence":"additional","affiliation":[{"name":"Research Institute, Medical University Pleven, 5800 Pleven, Bulgaria"},{"name":"Department of Gynecology, Hospital \u201cSaint Anna\u201d, 9002 Varna, Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Palumbo","sequence":"additional","affiliation":[{"name":"Department of Public Health, School of Medicine, University of Naples Federico II, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rosati","sequence":"additional","affiliation":[{"name":"Department of Woman\u2019s and Child Health and Public Health Sciences, Gynecologic Oncology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0515-1951","authenticated-orcid":false,"given":"Radmila","family":"Spari\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Belgrade, Dr Suboti\u0107a 8, 11000 Belgrade, Serbia"},{"name":"Clinic for Gynecology and Obstetrics, University Clinical Centre of Serbia, Dr Koste Todorovi\u0107a 26, 11000 Belgrade, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7194-6034","authenticated-orcid":false,"given":"Ibrahim","family":"Alkatout","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University Hospitals Schleswig-Holstein, Campus Kiel, Arnold-Heller-Strasse 3 (House C), 24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2178-6490","authenticated-orcid":false,"given":"Ingolf","family":"Juhasz-B\u00f6ss","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical Center\u2014University Hospital Freiburg, 79106 Freiburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6871-6097","authenticated-orcid":false,"given":"Salvatore Giovanni","family":"Vitale","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0610-5132","authenticated-orcid":false,"given":"Liliana","family":"Mereu","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Unit, Department of General Surgery and Medical Surgical Specialties, University of Catania, 95124 Catania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,4]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1093\/humupd\/dmz049","article-title":"Diagnosing Adenomyosis: An Integrated Clinical and Imaging Approach","volume":"26","author":"Chapron","year":"2020","journal-title":"Hum. 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