MicroRNAs as diagnostic biomarkers of myasthenia gravis: a systematic review and meta-analysis

Background Myasthenia gravis (MG) is an autoimmune neuromuscular disorder characterized by fluctuating muscle weakness. MicroRNAs (miRNAs) have emerged as potential biomarkers for MG diagnosis, offering noninvasive and reliable detection. This systematic review and meta-analysis evaluated the diagnostic accuracy of miRNAs in MG. Methods A comprehensive search of PubMed, Embase, and Google Scholar was conducted up to March 9, 2025. Eligible studies assessing miRNAs as MG biomarkers were selected on the basis of predefined criteria. Pooled sensitivity, specificity, and diagnostic odds ratios (DORs) were calculated via a bivariate random effects model. Heterogeneity was assessed via I², and publication bias was evaluated via Deeks’ funnel plot. Results Nine studies including 1,799 participants were analyzed. The pooled sensitivity and specificity were 0.80 (95% CI: 0.75–0.84) and 0.71 (95% CI: 0.65–0.77), respectively, with an area under the curve (AUC) of 0.83. Bivariate heterogeneity analysis indicated moderate variability, with standard deviations of 0.482 for sensitivity and 0.566 for specificity, suggesting methodological inconsistencies and population heterogeneity across studies. Conclusion miRNAs demonstrate strong diagnostic potential for MG, with good sensitivity and specificity. However, high heterogeneity and potential bias highlight the need for standardized methodologies and further validation in large, multicenter studies.