Kulus Magdalena, Farzaneh Maryam, Sheykhi-Sabzehpoush Mohadeseh, Ghaedrahmati Farhoodeh, Mehravar Fatemeh, Józkowiak Małgorzata, Piotrowska-Kempisty Hanna, Bukowska Dorota, Antosik Paweł, Podhorska-Okołów Marzenna, Zabel Maciej, Mozdziak Paul, Dzięgiel Piotr, Kempisty Bartosz
Department of Veterinary Surgery, Institute of Veterinary Medicine, Nicolaus Copernicus University in Torun, Torun 87-100, Poland.
Fertility, Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Biomed Pharmacother. 2025 Feb;183:117853. doi: 10.1016/j.biopha.2025.117853. Epub 2025 Jan 18.
Myocardial dysfunction, characterized by impaired cardiac muscle function, arises from diverse etiologies, including coronary artery disease, myocardial infarction, cardiomyopathies, hypertension, and valvular heart disease. Recent advancements have highlighted the roles of exosomes and non-coding RNAs in the pathophysiology of myocardial dysfunction. Exosomes are small extracellular vesicles released by cardiac and other cells that facilitate intercellular communication through their molecular cargo, including ncRNAs. ncRNAs are known to play critical roles in gene regulation through diverse mechanisms, impacting oxidative stress, fibrosis, and other factors associated with myocardial dysfunction. Dysregulation of these molecules correlates with disease progression, presenting opportunities for therapeutic interventions. This review explores the mechanistic interplay between exosomes and ncRNAs, underscoring their potential as biomarkers and therapeutic agents in myocardial dysfunction. Emerging evidence supports the use of engineered exosomes and modified ncRNAs to enhance cardiac repair by targeting signaling pathways associated with fibrosis, apoptosis, and angiogenesis. Despite promising preclinical results, delivery, stability, and immunogenicity challenges remain. Further research is needed to optimize clinical translation. Understanding these intricate mechanisms may drive the development of innovative strategies for diagnosing and treating myocardial dysfunction, ultimately improving patient outcomes.
心肌功能障碍以心肌功能受损为特征，由多种病因引起，包括冠状动脉疾病、心肌梗死、心肌病、高血压和心脏瓣膜病。最近的进展突出了外泌体和非编码RNA在心肌功能障碍病理生理学中的作用。外泌体是心脏和其他细胞释放的小细胞外囊泡，通过其分子货物（包括ncRNA）促进细胞间通讯。已知ncRNA通过多种机制在基因调控中发挥关键作用，影响氧化应激、纤维化和其他与心肌功能障碍相关的因素。这些分子的失调与疾病进展相关，为治疗干预提供了机会。本综述探讨了外泌体与ncRNA之间的机制相互作用，强调了它们作为心肌功能障碍生物标志物和治疗剂的潜力。新出现的证据支持使用工程化外泌体和修饰的ncRNA，通过靶向与纤维化、细胞凋亡和血管生成相关的信号通路来增强心脏修复。尽管临床前结果很有前景，但仍存在递送、稳定性和免疫原性挑战。需要进一步研究以优化临床转化。了解这些复杂机制可能推动诊断和治疗心肌功能障碍的创新策略的发展，最终改善患者预后。
