Revisiting miRNA-21 as a Therapeutic Strategy for Myocardial Infarction: A Systematic Review

Abstract

Several types of cardiovascular cells use microRNA-21 (miR-21), which has been linked to cardioprotection. In this study, we systematically reviewed the results of published papers on the therapeutic effect of miR-21 for myocardial infarction. Studies described the cardioprotective effects of miR-21 to reduce infarct size by improving angiogenesis, antiapoptotic, and antiinflammatory mechanisms. Results suggest that cardioprotective effects of miR-21 may work synergistically to prevent the deterioration of cardiac function during postischemia. However, there are other results that indicate that miR-21 positively regulates tissue fibrosis, potentially worsening a postischemic injury. The dual functionalities of miR-21 occur through the targeting of genes and signaling pathways, such as PTEN, PDCD4, KBTBD7, NOS3, STRN, and Spry-1. This review provides insights into the future advancement of safe miR-21-based genetic therapy in the treatment of myocardial infarction.

High-Density Lipoproteins at the Interface between the NLRP3 Inflammasome and Myocardial Infarction

“…Among these miR-NAs, miR-21's role remains somewhat enigmatic. While it exerts a protective effect against myocardial injury and pro-inflammatory modulation in the context of myocardial infarction, miR-21 is also implicated in the promotion of cardiac fibrosis post-MI, contributing to adverse cardiac remodeling [204][205][206]. Importantly, an intriguing hypothesis for future studies revolves around whether HDL particles have the capacity to modulate miRNA expression pathways or serve as carriers for specific miRNAs targeting cells during MI [207].…”

From multi-omics approaches to personalized medicine in myocardial infarction

“…Furthermore, abundant research suggests that miRNA hold promising potential in treating MI by regulating gene expression and crucial cellular processes. Key therapeutic candidates include miRNA-21 ( 145 – 147 ), miRNA-192-5p ( 148 ), and miRNA-432-5p ( 148 ), involved in inflammation and fibrosis; miRNA-499 ( 149 ), implicated in endothelial injury; miRNA-126 ( 150 , 151 ), contributing to angiogenesis; miRNA-133 ( 152 ), influencing cardiac function; and miRNA-208a ( 153 ), linked to fibrosis. Intervening with these miRNAs could fundamentally change MI treatment by adjusting core processes and facilitating cardiac recovery.…”

Recent Advances in Cell‐Based Nanotherapy for Cardiovascular Diseases

“…[ 260 ] miR‐21‐loaded MSC‐EVs appeared to be good candidates for cardiac tissue repair. [ 261 ] With miR‐21, Yao et al. [ 262 ] prepared a stem CM‐camouflaged nanocomplex to mimic exosomes and conquer the low yields of exosomes ( Figure 14 ).…”

“…[260] miR-21-loaded MSC-EVs appeared to be good candidates for cardiac tissue repair. [261] With miR-21, Yao et al [262] prepared a stem CM-camouflaged nanocomplex to mimic exosomes and conquer the low yields of exosomes (Figure 14). The nanocomplex can target ischemic injured cardiomyocytes and promote cardiomyocyte proliferation (Figure 14A-b).…”