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Figure 4. Summary of the roles of essential miRNAs including miR-96 in spinal cord injury (SCI). SCI affects the expression of miRNAs,
which are known to regulate processes such as cell proliferation, inflammation, and apoptosis. Particularly, miR-96 is essential for
neuroprotection as it induces multi-protective functions by targeting and down regulating FOXO pathways

Research shows that FOXO3a targets the cyclin-dependent kinase inhibitor p27kip1 and the pro-apoptotic
[78]
molecule Bim, a phenomenon that triggers apoptosis . Research has also shown that the effect of FOXO3a
[79]
in regulating apoptosis is dependent on the expression of death receptor ligands such as the FasL .
There is evidence showing that miR-96 causes a reduction in the levels of both FOXO1 and FOXO3a
[80]
for promoting cell proliferation , an effect that can be further investigated for neuroprotection and
regeneration in SCI.

CONCLUSION
Recent preclinical evidence makes it clear that miRNAs are useful therapeutic tools that modulate critical
molecular processes and enhance functional recovery after SCI. In this article, we have discussed some
examples, highlighting how the expression of miRNAs triggers complex interactions and changes at the
cellular and protein levels. These changes affect SCI pathophysiology and have been identified as regulators
and contributors to secondary injury. The assertions made in recent studies indicate that manipulating the
expression of miRNAs may provide an opportunity for developing the improved therapeutic and clinical
interventions for dealing with the devastating consequences of SCI [Figure 4]. In fact, it is essential to note
that not all miRNAs affect SCI positively. However, many of the miRNAs discussed in this review article
have been shown to contribute positively to the management of SCI. For example, miR-96 promotes axonal
growth, cell regeneration, neuroplasticity, and facilitates functional recovery, although more research is
needed in this regard.

DECLARATIONS
Authors’ contributions
Conceptualized the theme and conducted the literature review process: Almurshidi B
Contributed to preparation and revision of the manuscript, interpretation of subtopics, and preparation
figures: Almurshidi B, Ray SK
Approved the final version to be published: Almurshidi B, Carver W, Scott G, Ray SK