Zhuang Bingqi, Zhong Chongning, Ma Yuting, Wang Ao, Quan Hailian, Hong Lan
Department of Physiology and Pathophysiology, College of Medicine, Yanbian University, Yanji 133002, China.
Experimental Teaching Center, College of Pharmacy, Yanbian University, Yanji 133002, China.
Int J Mol Sci. 2024 Dec 30;26(1):231. doi: 10.3390/ijms26010231.
Myocardial infarction (MI) is a highly challenging and fatal disease, with diverse challenges arising at different stages of its progression. As such, non-coding RNAs (ncRNAs), which can broadly regulate cell fate, and stem cells with multi-differentiation potential are emerging as novel therapeutic approaches for treating MI across its various stages. NcRNAs, including microRNAs (miRNAs) and long non-coding RNAs (LncRNAs), can directly participate in regulating intracellular signaling pathways, influence cardiac angiogenesis, and promote the repair of infarcted myocardium. Currently, stem cells commonly used in medicine, such as mesenchymal stem cells (MSCs) and induced pluripotent stem cells (iPSCs), can differentiate into various human cell types without ethical concerns. When combined with ncRNAs, these stem cells can more effectively induce directed differentiation, promote angiogenesis in the infarcted heart, and replenish normal cardiac cells. Additionally, stem cell-derived exosomes, which contain various ncRNAs, can improve myocardial damage in the infarcted region through paracrine mechanisms. However, our understanding of the specific roles and mechanisms of ncRNAs, stem cells, and exosomes secreted by stem cells during different stages of MI remains limited. Therefore, this review systematically categorizes the different stages of MI, aiming to summarize the direct regulatory effects of ncRNAs on an infarcted myocardium at different points of disease progression. Moreover, it explores the specific roles and mechanisms of stem cell therapy and exosome therapy in this complex pathological evolution process. The objective of this review was to provide novel insights into therapeutic strategies for different stages of MI and open new research directions for the application of stem cells and ncRNAs in the field of MI repair.
心肌梗死（MI）是一种极具挑战性的致命疾病，在其进展的不同阶段会出现各种挑战。因此，能够广泛调节细胞命运的非编码RNA（ncRNAs）以及具有多分化潜能的干细胞正成为治疗MI各个阶段的新型治疗方法。ncRNAs，包括微小RNA（miRNAs）和长链非编码RNA（LncRNAs），可以直接参与调节细胞内信号通路，影响心脏血管生成，并促进梗死心肌的修复。目前，医学上常用的干细胞，如间充质干细胞（MSCs）和诱导多能干细胞（iPSCs），可以分化为各种人类细胞类型，且不存在伦理问题。当与ncRNAs结合时，这些干细胞可以更有效地诱导定向分化，促进梗死心脏的血管生成，并补充正常的心肌细胞。此外，含有各种ncRNAs的干细胞衍生外泌体可以通过旁分泌机制改善梗死区域的心肌损伤。然而，我们对ncRNAs、干细胞以及干细胞分泌的外泌体在MI不同阶段的具体作用和机制的了解仍然有限。因此，本综述系统地对MI的不同阶段进行了分类，旨在总结ncRNAs在疾病进展不同点对梗死心肌的直接调节作用。此外，还探讨了干细胞疗法和外泌体疗法在这一复杂病理演变过程中的具体作用和机制。本综述的目的是为MI不同阶段的治疗策略提供新的见解，并为干细胞和ncRNAs在MI修复领域的应用开辟新的研究方向。
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