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RNA therapeutics in cardiovascular precision medicine

Lookup NU author(s): Professor Konstantinos Stellos

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2018 Laina, Gatsiou, Georgiopoulos, Stamatelopoulos and Stellos. Since our knowledge on structure and function of messenger RNA (mRNA) has expanded from merely being an intermediate molecule between DNA and proteins to the notion that RNA is a dynamic gene regulator that can be modified and edited, RNA has become a focus of interest into developing novel therapeutic schemes. Therapeutic modulation of RNA molecules by DNA- and RNA-based therapies has broadened the scope of therapeutic targets in infectious diseases, cancer, neurodegenerative diseases and most recently in cardiovascular diseases as well. Currently, antisense oligonucleotides (ASO), small interfering RNAs (siRNAs), and microRNAs are the most widely applied therapeutic strategies to target RNA molecules and regulate gene expression and protein production. However, a number of barriers have to be overcome including instability, inadequate binding affinity and delivery to the tissues, immunogenicity, and off-target toxicity in order for these agents to evolve into efficient drugs. As cardiovascular diseases remain the leading cause of mortality worldwide, a large number of clinical trials are under development investigating the safety and efficacy of RNA therapeutics in clinical conditions such as familial hypercholesterolemia, diabetes mellitus, hypertriglyceridemia, cardiac amyloidosis, and atrial fibrillation. In this review, we summarize the clinical trials of RNA-targeting therapies in cardiovascular disease and critically discuss the advances, the outcomes, the limitations and the future directions of RNA therapeutics in precision transcriptomic medicine.


Publication metadata

Author(s): Laina A, Gatsiou A, Georgiopoulos G, Stamatelopoulos K, Stellos K

Publication type: Review

Publication status: Published

Journal: Frontiers in Physiology

Year: 2018

Volume: 9

Online publication date: 25/07/2018

Acceptance date: 28/06/2018

ISSN (electronic): 1664-1078

Publisher: Frontiers Media S.A.

URL: https://doi.org/10.3389/fphys.2018.00953

DOI: 10.3389/fphys.2018.00953


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