Research progress of non-coding RNAs in intrauterine adhesion

Intrauterine adhesion (IUA), also known as Asherman' s syndrome, is a common reproductive system disorder in women of reproductive age, often occurring as a result of postpartum infection, uterine surgery, or genital tuberculosis. IUA is a fibrotic disease caused by tissue damage. When the trauma to the endometrial basement membrane leads to repair disorder, excessive deposition and reorganization of extracellular matrix and proliferation of fibrous connective tissue replace the normal endometrium. This can ultimately cause partial or complete obstruction of uterine cavity or cervical canal, which may lead to various complications, including cyclical pelvic pain, menstrual disturbance, and disminished fertility, seriously affecting the physical and mental health of women. Transcervical resection of adhesion is the current method for IUA treatment, but the high recurrence rate of postoperative adhesion and subsequent infertility make the treatment of IUA still a significant challenge. Non-coding RNAs (ncRNAs), a class of RNA molecules that lack protein-coding capacity, are integral to the regulation of gene expression and are significant contributors to the metabolic life activity of organisms and the development of diseases. Recent studies have identified associations between TGF-β1/Smad, Wnt/β-catenin, and NF-κB signaling pathways and the development of IUA. ncRNAs potentially modulate endometrial fibrogenesis by targeting key components within these pathways. ncRNAs mainly include microRNA (miRNA), long non-coding RNA (lncRNA), and circular RNA (circRNA), which are expected to be therapeutic targets and diagnostic markers for IUA. This review summarizes the progress of research on ncRNAs and IUA, to offer novel insights for the prevention and treatment of IUA, ultimately enhancing patients' quality of life.