Key result
MicroRNAs regulate key pathways in valvular heart diseases and represent promising diagnostic biomarkers and therapeutic targets, despite challenges with drug instability and pharmacokinetics.
Why the study?
miRNAs have emerged as key regulators of valvular disease pathogenesis, diagnostic biomarkers, and therapeutic targets, warranting a comprehensive review of their biological signals and translational potential.
This review highlights the emerging role of miRNAs as biological regulators, prognostic markers, and therapeutic targets in valvular heart diseases, while outlining the technical challenges of miRNA-based drug delivery.
miRNA expression patterns may refine valvular prognosis; leaves open validation in prospective cohorts before clinical use.
miRNAs have recently attracted investigators' interest as regulators of valvular diseases pathogenesis, diagnostic biomarkers, and therapeutical targets. Evidence from in-vivo and in-vitro studies demonstrated stimulatory or inhibitory roles in mitral valve prolapse development, aortic leaflet fusion, and calcification pathways, specifically osteoblastic differentiation and transcription factors modulation. Tissue expression assessment and comparison between physiological and pathological phenotypes of different disease entities, including mitral valve prolapse and mitral chordae tendineae rupture, emerged as the best strategies to address miRNAs over or under-representation and thus, their impact on pathogeneses. In this review, we discuss the fundamental intra- and intercellular signals regulated by miRNAs leading to defects in mitral and aortic valves, congenital heart diseases, and the possible therapeutic strategies targeting them. These miRNAs inhibitors are comprised of antisense oligonucleotides and sponge vectors. The miRNA mimics, miRNA expression vectors, and small molecules are instead possible practical strategies to increase specific miRNA activity. Advantages and technical limitations of these new drugs, including instability and complex pharmacokinetics, are also presented. Novel delivery strategies, such as nanoparticles and liposomes, are described to improve knowledge on future personalized treatment directions.
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Nappi et al. (2021) conducted a review in Valvular heart diseases. microRNAs was evaluated. MicroRNAs regulate key pathways in valvular heart diseases and represent promising diagnostic biomarkers and therapeutic targets, despite challenges with drug instability and pharmacokinetics.
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