title: Modulating microRNAs in cardiac surgery patients: Novel therapeutic opportunities?
abstract: This review focuses on microRNAs (miRs) in cardiac surgery, where they are emerging as potential targets for therapeutic intervention as well as novel clinical biomarkers. Identification of the up/down-regulation of specific miRs in defined groups of cardiac surgery patients can lead to the development of novel strategies for targeted treatment in order to maximise therapeutic results and minimise acute, delayed or chronic complications. MiRs could also be involved in determining the outcome independently of complications, for example in relation to myocardial perfusion and fibrosis. Because of their relevance in disease, their known sequence and pharmacological properties, miRs are attractive candidates for therapeutic manipulation. Pharmacological inhibition of individual miRs can be achieved by modified antisense oligonucleotides, referred to as antimiRs, while miR replacement can be achieved by miR mimics to increase the level of a specific miR. MiR mimics can restore the function of a lost or down-regulated miR, while antimiRs can inhibit the levels of disease-driving or aberrantly expressed miRs, thus de-repressing the expression of mRNAs targeted by the miR. The main delivery methods for miR therapeutics involve lipid-based vehicles, viral systems, cationic polymers, and intravenous or local injection of an antagomiR. Local delivery is particularly desirable for miR therapeutics and options include the development of devices specific for local delivery, light-induced antimiR, and vesicle-encapsulated miRs serving as therapeutic delivery agents able to improve intracellular uptake. Here, we discuss the potential therapeutic use of miRNAs in the context of cardiac surgery.
authors.affiliation: Bristol Heart Institute, University of Bristol, Bristol, UK.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Biglino
authors.affiliation: Bristol Heart Institute, University of Bristol, Bristol, UK; RUSH University Medical Center, Chicago, IL, USA.
authors.forename: Massimo
authors.initials: M
authors.lastname: Caputo
authors.affiliation: Bristol Heart Institute, University of Bristol, Bristol, UK.
authors.forename: Cha
authors.initials: C
authors.lastname: Rajakaruna
authors.affiliation: Bristol Heart Institute, University of Bristol, Bristol, UK.
authors.forename: Gianni
authors.initials: G
authors.lastname: Angelini
authors.affiliation: Hubrecht Institute, Utrecht, The Netherlands.
authors.forename: Eva
authors.initials: E
authors.lastname: van Rooij
authors.affiliation: Bristol Heart Institute, University of Bristol, Bristol, UK; National Heart and Lung Institute, Imperial College London, London, UK. Electronic address: Costanza.Emanueli@bristol.ac.uk.
authors.forename: Costanza
authors.initials: C
authors.lastname: Emanueli
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism; D006348:Cardiac Surgical Procedures / Q000379:methods*; D015536:Down-Regulation / Q000235:genetics; D006801:Humans; D035683:MicroRNAs / Q000378:metabolism*; D016376:Oligonucleotides, Antisense / Q000008:administration & dosage; D011183:Postoperative Complications / Q000517:prevention & control*; D015854:Up-Regulation / Q000235:genetics
chemical_list: D015415:Biomarkers; D035683:MicroRNAs; D016376:Oligonucleotides, Antisense
keywords: Angiogenesis; Cardiac protection; Cardiac surgery; MicroRNA; Therapeutic