Advanced Center for Chronic Diseases (ACCDiS) & Center for Molecular Studies of the Cell (CEMC), Faculty of Chemical and Pharmaceutical Sciences & Faculty of Medicine, University of Chile, Santiago. Chile.
Faculty of Health Sciences, Universidad Libre, Barranquilla. Colombia.
Curr Pharm Des. 2017;23(18):2592-2615. doi: 10.2174/1381612823666170112122637.
Cardiovascular disease is the leading cause of death worldwide. The heart is susceptible to pathologies that impact the myocardium directly, such as myocardial infarction and consequent heart failure, as well as conditions with indirect cardiac effects, such as cancer treatment-related cardiotoxicity. As the contractile cells of the heart, cardiomyocytes are essential for normal cardiac function. Various stress stimuli may result in transient damage or cell death in cardiomyocytes through apoptosis, necrosis or maladaptive autophagy. Moreover, cardiomyocytes are unable to regenerate; thus, lost cells are replaced with fibrotic tissue, with a potentially severe impact on myocardial function. Several therapeutic agents and strategies to reduce cardiomyocyte damage are currently available. This manuscript reviews the state of the art regarding novel cardioprotective endogenous peptides, such as neuregulin-1, angiotensin-(1-9), growth/differentiation factor-11, growth/differentiation factor- 15 and insulin-like growth factor-1. We discuss their protective effects and therapeutic potential in cardiovascular diseases and the current challenges to harnessing their full cardioprotective power. We also explore targeting of exosomes as a cardioprotective approach along with the therapeutic potential of cardiac regeneration strategies. Further advances associated with these molecules and cardioprotective approaches may provide more effective therapies to attenuate or prevent cardiomyocyte death, thereby preserving the myocardium.
心血管疾病是全球范围内的主要死亡原因。心脏容易受到直接影响心肌的病理变化，如心肌梗死和随之而来的心力衰竭，以及间接影响心脏的情况，如癌症治疗相关的心脏毒性。作为心脏的收缩细胞，心肌细胞对于正常的心脏功能至关重要。各种应激刺激可通过细胞凋亡、坏死或适应性自噬导致心肌细胞短暂损伤或死亡。此外，心肌细胞不能再生；因此，丢失的细胞被纤维组织取代，这可能对心肌功能产生严重影响。目前有几种治疗剂和策略可减少心肌细胞损伤。本文综述了新型心脏保护内源性肽，如神经调节素-1、血管紧张素-(1-9)、生长/分化因子-11、生长/分化因子-15 和胰岛素样生长因子-1 的最新研究进展。我们讨论了它们在心血管疾病中的保护作用和治疗潜力，以及充分发挥其心脏保护作用所面临的当前挑战。我们还探讨了外泌体作为心脏保护方法的靶向治疗以及心脏再生策略的治疗潜力。这些分子和心脏保护方法的进一步进展可能为减轻或预防心肌细胞死亡提供更有效的治疗方法，从而保护心肌。
