Emerging roles of RNA N4-acetylcytidine modification in reproductive health

N4-acetylcytidine (ac⁴C), an emerging post-transcriptional RNA modification, plays a pivotal role in epigenetic regulation. Ac⁴C is detected not only in tRNA, rRNA and mRNA, but also in miRNA, lncRNA, viral RNA, and even DNA. Functionally, ac⁴C stabilizes mRNA, enhances protein translation fidelity, and impacts various biological processes and diseases such as cancer, inflammation, immune regulation, neural diseases, osteogenic differentiation, cardiovascular diseases, viral infections, and replication. Current research primarily focuses on ac⁴C’s roles in cancer progression and immunity, with emerging findings in gynecological diseases and reproduction. However, a comprehensive understanding of ac4C's implications in reproductive health is lacking. This review provides a historical perspective on ac⁴C's discovery and detection methods, elucidates its functions in reproductive development and gynecological disorders, and offers insights for further research in reproductive health. This review aims to pave the way for innovative therapeutic approaches and precise diagnostic tools tailored to this field.