Tyagi Suresh C, Joshua Irving G
Department of Physiology and Biophysics, University of Louisville School of Medicine, 323 East Chestnut Street, Louisville, KY 40202, USA.
Can J Physiol Pharmacol. 2014 Jul;92(7):521-3. doi: 10.1139/cjpp-2014-0197.
Remodeling and myocardial matrix metabolism contributes to cardiac endothelium-myocyte (perivascular fibrosis), myocyte-myocyte (interstitial fibrosis), and mitochondrion-myocyte (fusion and fission) coupling. Matrix metalloproteinases (MMPs), and tissue inhibitor of metalloproteinases (TIMPs) play differential roles in different tissues and diseases. For example, although present in the heart, MMP-3 is known as stromelysin (i.e., stromal tissue enzyme). Interestingly, TIMP-3 causes apoptosis. Exercise and nutrition are synergistic in the mitigation of diseases: exercise releases exosomes containing miRNAs. Nutrition/vitamins B6 and B12 regulate the metabolism of homocysteine (an epigenetic byproduct of DNA/RNA/protein methylation). Thus, epigenetic silencing is an important therapeutic target. The statistical analysis of cohorts may be less indicative for the treatment of a disease, particularly if the 2 twins are different in terms of responding to the medicine for the same disease, therefore, personalized medicine is the future of therapy.
重塑和心肌基质代谢有助于心脏内皮细胞与心肌细胞（血管周围纤维化）、心肌细胞与心肌细胞（间质纤维化）以及线粒体与心肌细胞（融合与裂变）之间的偶联。基质金属蛋白酶（MMPs）和金属蛋白酶组织抑制剂（TIMPs）在不同组织和疾病中发挥不同作用。例如，尽管MMP - 3存在于心脏中，但它被称为基质溶解素（即基质组织酶）。有趣的是，TIMP - 3会导致细胞凋亡。运动和营养在减轻疾病方面具有协同作用：运动释放含有微小RNA的外泌体。营养/维生素B6和B12调节同型半胱氨酸（DNA/RNA/蛋白质甲基化的一种表观遗传副产物）的代谢。因此，表观遗传沉默是一个重要的治疗靶点。队列的统计分析对于疾病治疗的指示性可能较小，特别是如果同卵双胞胎对同一种疾病的药物反应不同，因此，个性化医疗是治疗的未来方向。
