Clinic of Cardiology, Mustafakemalpaşa State Hospital, Bursa, Turkey
Department of Cardiology, University of Health Sciences, Bursa Yüksek İhtisas Research and Training Hospital, Bursa, Turkey
Balkan Med J. 2020 Feb 28;37(2):60-71. doi: 10.4274/balkanmedj.galenos.2020.2020.1.94. Epub 2020 Feb 5.
Cardiovascular diseases are one of the most common causes of death in both developing and developed countries worldwide. Even though there have been improvements in primary prevention, the prevalence of cardiovascular diseases continues to increase in recent years. Hence, it is crucial to both investigate the molecular pathophysiology of cardiovascular diseases in-depth and find novel biomarkers regarding the early and proper prevention and diagnosis of these diseases. MicroRNAs, or miRNAs, are endogenous, conserved, single-stranded non-coding RNAs of 21-25 nucleotides in length. miRNAs have important roles in various cellular events such as embryogenesis, proliferation, vasculogenesis, apoptosis, cell growth, differentiation, and tumorigenesis. They also have potential roles in the cardiovascular system, including angiogenesis, cardiac cell contractility, control of lipid metabolism, plaque formation, the arrangement of cardiac rhythm, and cardiac cell growth. Circulating miRNAs are promising novel biomarkers for purposes of the diagnosis and prognosis of cardiovascular diseases. Cell or tissue specificity, stability in serum or plasma, resistance to degradative factors such as freeze-thaw cycles or enzymes in the blood, and fast-release kinetics, provide the potential for miRNAs to be surrogate markers for the early and accurate diagnosis of disease and for predicting middle- or long-term prognosis. Moreover, it may be a logical approach to combine miRNAs with traditional biomarkers to improve risk stratification and long-term prognosis. In addition to their efficacy in both diagnosis and prognosis, miRNA-based therapeutics may be beneficial for treating cardiovascular diseases using novel platforms and computational tools and in combination with traditional methods of analysis. microRNAs are promising, novel therapeutic agents, which can affect multiple genes using different signaling pathways. miRNAs therapeutic modulation techniques have been used in the settings of atherosclerosis, acute myocardial infarction, restenosis, vascular remodeling, arrhythmias, hypertrophy and fibrosis, angiogenesis and cardiogenesis, aortic aneurysm, pulmonary hypertension, and ischemic injury. This review presents detailed information about miRNAs regarding structure and biogenesis, stages of synthesis and functions, expression profiles in serum/plasma of living organisms, diagnostic and prognostic potential as novel biomarkers, and therapeutic applications in various diseases.
心血管疾病是全球发展中国家和发达国家最常见的死亡原因之一。尽管在一级预防方面已经有所改善,但近年来心血管疾病的患病率仍在持续上升。因此,深入研究心血管疾病的分子病理生理学,并寻找新型生物标志物,对于这些疾病的早期和适当预防和诊断至关重要。微小 RNA(miRNA)是长度为 21-25 个核苷酸的内源性、保守、单链非编码 RNA。miRNA 在胚胎发生、增殖、血管生成、细胞凋亡、细胞生长、分化和肿瘤发生等多种细胞事件中发挥重要作用。它们在心血管系统中也具有潜在作用,包括血管生成、心肌细胞收缩力、脂质代谢控制、斑块形成、心脏节律排列和心肌细胞生长。循环 miRNA 是诊断和预测心血管疾病的有前途的新型生物标志物。细胞或组织特异性、在血清或血浆中的稳定性、对冻融循环或血液中酶等降解因子的抗性以及快速释放动力学,为 miRNA 成为疾病早期和准确诊断以及预测中期或长期预后的替代标志物提供了潜力。此外,将 miRNA 与传统生物标志物相结合,以改善风险分层和长期预后,可能是一种合理的方法。除了在诊断和预后方面的有效性外,基于 miRNA 的治疗方法可能有益于使用新型平台和计算工具以及结合传统分析方法治疗心血管疾病。miRNA 是有前途的新型治疗剂,可通过不同的信号通路影响多个基因。miRNA 治疗调节技术已应用于动脉粥样硬化、急性心肌梗死、再狭窄、血管重塑、心律失常、肥大和纤维化、血管生成和心肌生成、主动脉瘤、肺动脉高压和缺血性损伤等疾病。本综述详细介绍了 miRNA 关于结构和生物发生、合成阶段和功能、生物体血清/血浆中的表达谱、作为新型生物标志物的诊断和预后潜力以及在各种疾病中的治疗应用。