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Advances in MicroRNA Therapy for Heart Failure: Clinical Trials, Preclinical Studies, and Controversies

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Abstract

Heart failure (HF) is a rapidly growing public health issue with more than 37.7 million patients worldwide and an annual healthcare cost of $108 billion. However, HF-related drugs have not changed significantly for decades, and it is essential to find biological drugs to provide better treatment for HF patients. MicroRNAs (miRNAs) are non-coding RNAs (ncRNAs) with a length of approximately 21 nucleotides and play an important role in the onset and progression of cardiovascular diseases. Increasing studies have shown that miRNAs are widely involved in the pathophysiology of HF, and the regulation of miRNAs has promising therapeutic effects. Among them, there is great interest in miRNA-132, since the encouraging success of anti-miRNA-132 therapy in a phase 1b clinical trial in 2020. However, it is worth noting that the multi-target effect of miRNA may produce side effects such as thrombocytopenia, revascularization dysfunction, severe immune response, and even death. Advances in drug delivery modalities, delivery vehicles, chemical modifications, and plant-derived miRNAs are expected to address safety concerns and further improve miRNA therapy. Here, we reviewed the preclinical studies and clinical trials of HF-related miRNAs (especially miRNA-132) in the past 5 years and summarized the controversies of miRNA therapy.

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Data Availability

The datasets from the current study are available from the corresponding author upon reasonable request.

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Funding

This work was supported by the Science and Technology Innovation Program of Hunan Province (2021RC2106 to CF).

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Middle Renmin Road 139, Changsha, 410011, China

    Shengyuan Huang, Liming Liu & Chengming Fan

  2. Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, China

    Yong Zhou

  3. Department of Laboratory Medicine, The Second Xiangya Hospital, Central South University, Changsha, China

    Yiru Zhang

  4. Department of Radiology, The Second Xiangya Hospital, Central South University, Changsha, China

    Ningyuan Liu

  5. Xiangya Medical College of Central South University, Changsha, China

    Jiachen Liu

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SH drafted the manuscript. SH and CF designed the study. Yong Zhou, Yiru Zhang, NL, JL, and LL revised the manuscript. SH was responsible for the collection of data or analysis. All authors read and approved the final manuscript.

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Correspondence to Chengming Fan.

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Huang, S., Zhou, Y., Zhang, Y. et al. Advances in MicroRNA Therapy for Heart Failure: Clinical Trials, Preclinical Studies, and Controversies. Cardiovasc Drugs Ther (2023). https://doi.org/10.1007/s10557-023-07492-7

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