Targeting the IKKα/NF-κB Axis with SGEC-Derived Exosomal miR-23b-3p Rebalances Treg/Th17 Immunity in Sjögren's Syndrome

Antioxid Redox Signal. 2026 Sep;45(7-9):376-396. doi: 10.1177/15230864261443868. Epub 2026 Jun 8.

Abstract

Background: Sjögren's syndrome (SS) is a systemic autoimmune disorder characterized by chronic inflammation, oxidative stress, and progressive salivary gland dysfunction. Current therapies remain limited in efficacy.

Aim: This study explored the regulatory effect of exosome (Exo)-transported miR-23b-3p on the IκB kinase alpha (IKKα)/nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling axis in SS.

Methods: Key SS-related microRNAs (miRNAs) were identified by integrating weighted gene co-expression network analysis with machine-learning-based transcriptomic profiling. Target genes and functional pathways were analyzed by bioinformatics methods. The direct binding between miR-23b and IKKα (CHUK) was validated by a dual-luciferase reporter assay. An in vitro SS cell model was established to examine the effects of miR-23b-3p on the IKKα/NF-κB pathway, oxidative stress, inflammation, and apoptosis. miR-23b-3p was loaded into salivary gland epithelial cell-derived Exos (SGEC-Exos) via electroporation. In vitro coculture experiments assessed reactive oxygen species (ROS) levels, inflammatory cytokines, Treg/Th17 balance, and cell apoptosis. In vivo effects were evaluated in NOD/Ltj mice by measuring salivary flow rate, histopathology, and expression of salivary-function-related proteins AQP5 and GPER.

Results: SGEC-Exos@miR-23b-3p significantly suppressed IKKα expression and NF-κB activation, reduced ROS production, and modulated immune responses by restoring the Treg/Th17 balance. It also inhibited apoptosis by decreasing Bax and caspase-3 expression and increasing Bcl-2 levels. These effects were partially reversed by reactivation of the IKKα/NF-κB pathway. In NOD/Ltj mice, SGEC-Exos@miR-23b-3p improved salivary flow, alleviated glandular pathology, and upregulated AQP5 and GPER expression.

Conclusions: SGEC-Exos@miR-23b-3p offers a translational approach to address oxidative stress, immune imbalance, and glandular injury in SS, highlighting the potential of Exo-based miRNA therapy. Antioxid. Redox Signal. 45, 376-396.

Keywords: Sjögren’s syndrome; exosomes; miR-23b-3p; salivary gland epithelial cells.

MeSH terms

  • Animals
  • Apoptosis
  • Epithelial Cells / metabolism
  • Exosomes* / genetics
  • Exosomes* / metabolism
  • Humans
  • I-kappa B Kinase* / genetics
  • I-kappa B Kinase* / metabolism
  • Mice
  • MicroRNAs* / genetics
  • NF-kappa B* / metabolism
  • Oxidative Stress
  • Salivary Glands / cytology
  • Salivary Glands / metabolism
  • Signal Transduction
  • Sjogren's Syndrome* / genetics
  • Sjogren's Syndrome* / immunology
  • Sjogren's Syndrome* / metabolism
  • Sjogren's Syndrome* / pathology
  • T-Lymphocytes, Regulatory* / immunology
  • T-Lymphocytes, Regulatory* / metabolism

Substances

  • MicroRNAs
  • I-kappa B Kinase
  • NF-kappa B
  • MIRN23b microRNA, human
  • CHUK protein, human