RNA interference (RNAi) is a potent biological mechanism enabling the targeted silencing of specific genes, transforming gene regulation and therapeutic approaches in medical science. Using small RNA molecules such as small interfering RNAs (siRNAs) and microRNAs (miRNAs), RNAi allows for precise mRNA degradation or translational repression. Clinically, RNAi has been applied to treat genetic disorders such as hereditary transthyretin amyloidosis (hATTR) and acute hepatic porphyria (AHP). RNAi also holds promise in cancer therapies, targeting oncogenes like KRAS and pathways such as PI3K/AKT/mTOR to slow tumor growth. However, several challenges limit RNAi's broader clinical adoption. A significant barrier is the development of effective delivery systems beyond liver cells, as current methods, such as lipid nanoparticles, have limitations in targeting other tissues. Furthermore, issues such as immune activation, off-target effects, and ensuring RNAi stability must be addressed. Regulatory hurdles concerning long-term safety and gene-silencing specificity also pose challenges. Looking ahead, advancements in next-generation RNAi molecules and delivery platforms, alongside combination therapies, offer promising solutions to overcome these limitations. his review explores the fundamental mechanisms of RNAi, including its role in gene regulation and gene silencing, and highlights its clinical applications in treating genetic disorders, cancers, and viral infections
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