ABSTRACT RNA‐targeted therapy is reshaping molecular medicine by shifting the traditional “protein‐centric” view toward an “RNA‐regulatory network” paradigm. Beyond carrying genetic information, RNA plays essential roles in posttranscriptional regulation, signaling pathways, and epigenetic modulation. Advances in high‐throughput sequencing, structural biology, and delivery technologies have accelerated the development of diverse RNA therapeutics, including antisense oligonucleotides (ASOs), small interfering RNA (siRNA), microRNA (miRNA) modulators, messenger RNA (mRNA) therapeutics, aptamers, short hairpin RNA, and CRISPR/Cas‐guided single‐guide RNAs. However, a concise comparison of these major RNA modalities and the translational barriers that limit their broader clinical application is still lacking. This review outlines the mechanisms and representative applications of these RNA‐based strategies in gene silencing, editing, protein replacement, immune activation, and targeted drug delivery. Special emphasis is placed on ASOs and siRNAs for neurological, metabolic, and infectious diseases, as well as mRNA therapeutics that are transforming vaccine development. Common challenges‐such as in vivo stability, delivery efficiency, and immune activation‐are also discussed. Finally, we highlight how chemical modification, nanotechnology, and artificial intelligence‐assisted design are enhancing the specificity, stability, and safety of RNA therapeutics, providing a framework for advancing next‐generation precision RNA medicine.
Zhang et al. (2026) studied this question.