Nephrology and Dialysis Unit, Department of Medical and Surgical Sciences, University "Magna-Graecia" of Catanzaro, Viale Europa SNC, 88100 Catanzaro, Italy.
Int J Mol Sci. 2023 Mar 12;24(6):5425. doi: 10.3390/ijms24065425.
Uremic Cardiomyopathy (UCM) is an irreversible cardiovascular complication that is highly pervasive among chronic kidney disease (CKD) patients, particularly in End-Stage Kidney Disease (ESKD) individuals undergoing chronic dialysis. Features of UCM are an abnormal myocardial fibrosis, an asymmetric ventricular hypertrophy with subsequent diastolic dysfunction and a complex and multifactorial pathogenesis where underlying biological mechanisms remain partly undefined. In this paper, we reviewed the key evidence available on the biological and clinical significance of micro-RNAs (miRNAs) in UCM. miRNAs are short, noncoding RNA molecules with regulatory functions that play a pivotal role in myriad basic cellular processes, such as cell growth and differentiation. Deranged miRNAs expression has already been observed in various diseases, and their capacity to modulate cardiac remodeling and fibrosis under either physiological or pathological conditions is well acknowledged. In the context of UCM, robust experimental evidence confirms a close involvement of some miRNAs in the key pathways that are known to trigger or worsen ventricular hypertrophy or fibrosis. Moreover, very preliminary findings may set the stage for therapeutic interventions targeting specific miRNAs for ameliorating heart damage. Finally, scant but promising clinical evidence may suggest a potential future application of circulating miRNAs as diagnostic or prognostic biomarkers for improving risk stratification in UCM as well.
尿毒症性心肌病（UCM）是一种不可逆的心血管并发症，在慢性肾脏病（CKD）患者中非常普遍，特别是在接受慢性透析的终末期肾病（ESKD）患者中。UCM 的特征是心肌纤维化异常、不对称性心室肥厚导致随后的舒张功能障碍，以及发病机制复杂且多因素，其中潜在的生物学机制仍部分未定义。在本文中，我们回顾了 miRNA 在 UCM 中的生物学和临床意义的关键证据。miRNA 是具有调节功能的短非编码 RNA 分子，在细胞生长和分化等多种基本细胞过程中发挥关键作用。已经在各种疾病中观察到 miRNA 表达失调，并且它们在生理或病理条件下调节心脏重构和纤维化的能力已得到充分证实。在 UCM 中，强有力的实验证据证实了一些 miRNA 密切参与已知触发或加重心室肥厚或纤维化的关键途径。此外，非常初步的发现可能为针对特定 miRNA 的治疗干预铺平道路，以改善心脏损伤。最后，虽然很少但有希望的临床证据可能表明循环 miRNA 作为诊断或预后生物标志物在改善 UCM 风险分层方面具有潜在的未来应用。
