Center of Clinical Pathology and Innovative Therapy, Italian National Research Center on Aging (INRCA-IRCCS), Ancona, Italy.
Center of Clinical Pathology and Innovative Therapy, Italian National Research Center on Aging (INRCA-IRCCS), Ancona, Italy.
Exp Gerontol. 2017 Dec 15;100:17-27. doi: 10.1016/j.exger.2017.10.016. Epub 2017 Oct 23.
Cardiovascular disease (CVD) is an important public health problem affecting especially the elderly. Over the past 20years, an increasing number of studies have examined its underlying pathophysiological mechanisms and new therapies are continually being discovered. However, despite considerable progress in CVD management, mortality and morbidity remain a major healthcare concern, and frequent hospital admissions compromise the daily life and social activities of these patients. Physical activity has emerged as an important non-pharmacological adjunctive therapy for CVD in older patients, especially for heart failure patients, exerting its beneficial effects on mortality, morbidity, and functional capacity. The mechanisms underlying the cardiovascular benefits of exercise are not wholly clear. Mounting evidence suggest that epigenetic modifications, such as DNA methylation, histone post-translational modifications (hPTMs) and non-coding RNA, especially microRNAs (miRNAs), may be induced by physical activity. Recently, a number of miRNAs have been identified as key players in gene expression modulation by exercise. MiRNAs are synthesized by living cells and actively released into the bloodstream through different shuttles. The epigenetic information, thus carried and delivered, is involved in the interplay between environmental factors, including physical activity, and individual genetic make-up. We review and discuss the effects of exercise on age-related CVDs, focusing on circulating miRNA (c-miRNAs) modulation. Epigenetic mechanisms may have clinical relevance in CVD prevention and management; since they can be modified, insights into the implications of lifestyle-related epigenetic changes in CVD etiology may help develop therapeutic protocols of exercise training that can be suitable and effective for elderly patients.
心血管疾病（CVD）是一个重要的公共卫生问题，尤其影响老年人。在过去的 20 年中，越来越多的研究探讨了其潜在的病理生理机制，并且不断发现新的治疗方法。然而，尽管 CVD 管理取得了相当大的进展，死亡率和发病率仍然是医疗保健的主要关注点，频繁的住院治疗会影响这些患者的日常生活和社会活动。对于老年患者，尤其是心力衰竭患者，身体活动已成为 CVD 的一种重要非药物辅助治疗方法，对死亡率、发病率和功能能力都有有益影响。运动对心血管的益处的机制尚不完全清楚。越来越多的证据表明，表观遗传修饰，如 DNA 甲基化、组蛋白翻译后修饰（hPTMs）和非编码 RNA，特别是 microRNAs（miRNAs），可能是由身体活动引起的。最近，已经确定了许多 miRNA 是运动调节基因表达的关键因素。miRNA 是由活细胞合成的，并通过不同的载体主动释放到血液中。这种携带和传递的表观遗传信息涉及环境因素（包括身体活动）与个体遗传构成之间的相互作用。我们综述并讨论了运动对与年龄相关的 CVD 的影响，重点关注循环 miRNA（c-miRNAs）的调节。表观遗传机制在 CVD 的预防和管理中可能具有临床相关性；由于它们可以被修饰，因此深入了解与生活方式相关的表观遗传变化对 CVD 病因学的影响可能有助于制定适合老年患者的运动训练治疗方案。
