Эпигенетические лекарства: новый рубеж в лечении сердечной недостаточности

Автор: Айтбаев К.А., Муркамилов И.Т., Муркамилова Ж.А., Фомин В.В., Кудайбергенова И.О., Юсупова Т.Ф., Юсупов Ф.А.

Журнал: Евразийский кардиологический журнал @eurasian-cardiology-journal

Рубрика: Обзор

Статья в выпуске: 4, 2023 года.

Бесплатный доступ

Раскрытие секретов гибкости генома не только способствовало развитию исследований в этой области, но также послужило толчком к разработке новых методов лечения болезней человека. Лучшее понимание биологии хроматина (комплексы ДНК/гистоны) и некодирующих РНК (нкРНК) позволило разработать эпигенетические (эпи) препараты, способные модулировать программы транскрипции, связанные с сердечно-сосудистыми заболеваниями. Это особенно относится к сердечной недостаточности, где было показано, что эпигенетические механизмы лежат в основе развития некоторых патологических процессов, таких как гипертрофия левого желудочка, фиброз, апоптоз кардиомиоцитов и дисфункция микрососудов. Ориентация на эпигенетические сигналы может представлять собой многообещающий подход, особенно у пациентов с сердечной недостаточностью с сохраненной фракцией выброса (СНсФВ), где прогноз остается неблагоприятным, а эффективных методов лечения пока не существует. В этих условиях эпигенетика может использоваться для разработки индивидуальных терапевтических подходов, что прокладывает путь к персонализированной медицине. Несмотря на то, что благоприятные эффекты эпи-препаратов привлекают всё большее внимание, количество эпигенетических соединений, используемых в клинической практике, остается низким, что свидетельствует о необходимости разработки более селективных эпи-препаратов. В настоящем обзоре мы приводим перечень новых перспективных эпи-препаратов для лечения сердечно-сосудистых заболеваний, с акцентом, главным образом, на СНсФВ. Терапевтический эффект этих препаратов обусловлен воздействием как минимум на один из трёх основных эпигенетических механизмов: метилирование ДНК, модификация гистонов и некодирующие РНК.

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Сердечная недостаточность, эпи-терапия, персонализированная медицина

Короткий адрес: https://sciup.org/143181072

IDR: 143181072   |   УДК: 616.43   |   DOI: 10.38109/2225-1685-2023-4-76-82

Epigenetic drugs: a new frontier in the treatment of heart failure

Uncovering the secrets of genome flexibility not only contributed to the development of research in this area, but also served as an impetus for the development of new treatments for human diseases. A better understanding of the biology of chromatin (DNA/histone complexes) and non-coding RNAs (ncRNAs) has enabled the development of epigenetic (epi) preparations capable of modulating transcriptional programs associated with cardiovascular disease. This is especially true in heart failure, where epigenetic mechanisms have been shown to underlie the development of several pathological processes such as left ventricular hypertrophy, fibrosis, cardiomyocyte apoptosis, and microvascular dysfunction. Targeting epigenetic signals may represent a promising approach, especially in patients with heart failure with preserved ejection fraction (HFpEF), where the prognosis remains poor and effective treatments are not yet available. Under these conditions, epigenetics can be used to develop individualized therapeutic approaches, paving the way for personalized medicine. Although the beneficial effects of epi-drugs are gaining more attention, the number of epigenetic compounds used in clinical practice remains low, suggesting the need to develop more selective epi-drugs. In this review, we present a list of new promising epi-drugs for the treatment of cardiovascular diseases, with a focus mainly on HFpEF. The therapeutic effect of these drugs is due to the impact on at least one of the three main epigenetic mechanisms: DNA methylation, histone modification, and non-coding RNA.

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Текст обзорной статьи Эпигенетические лекарства: новый рубеж в лечении сердечной недостаточности

Данная статья распространяется на условиях «открытого доступа», в соответствии с лицензией CC BY-NC-SA 4.0 («Attribution-NonCommercial-ShareAlike» / «Атрибуция-Не-коммерчески-Сохранение Условий» 4.0), которая разрешает неограниченное некоммерческое использование, распространение и воспроизведение на любом носителе при условии указания автора и источника. Чтобы ознакомиться с полными условиями данной лицензии на русском языке, посетите сайт: by-nc-sa/4.0/

UDC 616.43

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