Therapeutic Potential of miR-34b/miR-23a Modulation in Parkinson’s Disease via Keap1-Nrf2 and ULK1 Pathways

The role of PD as a disorder characterised by interrelated disruptions of oxidative stress regulation and autophagy, which are two pathways that play a central role in the vulnerability of dopaminergic neurons, is increasingly recognised. This systematic review was an investigation of therapeutic potential of miR-34b and miR-23a (microRNAs) that can influence the Keap1 Nrf2 antioxidant axis and ULK1-mediated autophagy pathway. The peer-reviewed articles that were synthesised included five articles published between 2021 and 2024 and synthesised with the use of structured data extraction, CASP appraisal, and thematic analysis. Results show that there is strong conceptual evidence that microRNA plays a role in oxidative stress and autophagy, but direct evidence that miR-34b or miR-23a is involved in Keap1 -Nrf2 regulation or ULK1 activation in PD-specific models is very weak. Although combinatorial targeting of autophagy and oxidative stress is a concept with potential, there are many limitations, such as pleiotropic miRNA effects, barriers to delivery, and the absence of PD-specific mechanistic research, which considerably restricts translational potential at the moment. Critical research gap that is found in this review: There is no primary experimental literature that directly manipulates miR-34b and miR-23a in verifiable models of PD to corroborate pathway-specific effects. It is crucial that this evidence base should be strengthened before dual-miRNA therapeutic approaches can advance to clinical use.