The understanding of circular RNAs as special triggers in carcinogenesis

Circular RNAs (circRNAs) are a large type of noncoding RNAs characterized by their circular shape resulting from covalently closed continuous loops. They are known to regulate gene expression in mammals. These tissue-specific transcripts are largely generated from exonic or intronic sequences of their host genes. Although several models of circRNA biogenesis have been proposed, the understanding of their origin is far from complete. Unlike other noncoding RNAs, circRNAs are widely expressed, highly conserved and stable in cytoplasm, which confer special functionalities to them. They are known to serve as microRNA (miRNA) sponges, regulators of alternative splicing, transcription factors and encode for proteins. The expression of circRNAs is associated with several pathological states and may potentially serve as novel diagnostic or predictive biomarkers. CircRNAs are known to regulate the expression of numerous cancer-related miRNAs. The circRNA-miRNA-mRNA axis is a known regulatory pattern of several cancer-associated pathways, with both agonist and antagonist effects on carcinogenesis. In consideration of their potential clinical relevance, circRNAs are at the center of ongoing research initiatives on cancer prevention and treatment. In this review, we discuss the current understanding of circRNAs and the prospects for their potential clinical application in the management of cancer patients.