Davari Mohsen, Khansari Mahmoud, Hosseini Sahar, Morovatshoar Reza, Azani Alireza, Mirzohreh Seyedeh Tarlan, Mahabadi Mohammadjavad Ashrafi, Ghasemi Moein, Meigoli Mohammad Saeed Soleimani, Nematollahi Sima Foroughi, Pourranjbar Sina, Behfar Qumars, Baghdadi Mandana, Hosseini Ahmad Mir
Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
Cardiology Department, Mentoring Program in Medical Sciences, MSA Research Group, Tehran, Iran.
J Cardiovasc Transl Res. 2025 Apr 8. doi: 10.1007/s12265-025-10609-y.
Myocardial ischemia-reperfusion injury (IRI) is a major issue in cardiovascular medicine, marked by tissue damage from the restoration of blood flow after ischemia. Opioids, known for their pain-relieving properties, have emerged as potential cardioprotective agents in IRI. Recent research suggests opioids influence epigenetic mechanisms-such as histone modifications and non-coding RNAs (ncRNAs)-which are essential for regulating gene expression and cellular responses during myocardial IRI. This review delves into how opioids like remifentanil affect histone modifications, DNA methylation, and ncRNAs, including microRNAs (miRNAs) and long non-coding RNAs (lncRNAs). Remifentanil postconditioning (RPC) reduces apoptosis in cardiomyocytes through histone deacetylation, specifically downregulating histone deacetylase 3 (HDAC3). Similarly, opioids impact miRNAs such as miR- 206 - 3p and miR- 320 - 3p, and lncRNAs like TINCR and UCA1, which influence apoptosis, inflammation, and oxidative stress. Understanding these interactions highlights the potential for opioid-based therapies in mitigating IRI-induced myocardial damage.
心肌缺血再灌注损伤（IRI）是心血管医学中的一个主要问题，其特征是缺血后血流恢复导致的组织损伤。以其止痛特性而闻名的阿片类药物已成为IRI中潜在的心脏保护剂。最近的研究表明，阿片类药物会影响表观遗传机制，如组蛋白修饰和非编码RNA（ncRNA），这些机制对于调节心肌IRI期间的基因表达和细胞反应至关重要。这篇综述深入探讨了瑞芬太尼等阿片类药物如何影响组蛋白修饰、DNA甲基化和ncRNA，包括微小RNA（miRNA）和长链非编码RNA（lncRNA）。瑞芬太尼后处理（RPC）通过组蛋白去乙酰化减少心肌细胞凋亡，特别是下调组蛋白去乙酰化酶3（HDAC3）。同样，阿片类药物会影响miR-206-3p和miR-320-3p等miRNA，以及TINCR和UCA1等lncRNA，这些都会影响细胞凋亡、炎症和氧化应激。了解这些相互作用凸显了基于阿片类药物的疗法在减轻IRI诱导的心肌损伤方面的潜力。
