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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">evrazkar</journal-id><journal-title-group><journal-title xml:lang="ru">Евразийский Кардиологический Журнал</journal-title><trans-title-group xml:lang="en"><trans-title>Eurasian heart journal</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2225-1685</issn><issn pub-type="epub">2305-0748</issn><publisher><publisher-name>Евразийская ассоциация кардиологов</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.38109/2225-1685-2023-3-82-88</article-id><article-id custom-type="elpub" pub-id-type="custom">evrazkar-6406</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW</subject></subj-group></article-categories><title-group><article-title>МикроРНК: взгляд клинициста на состояние проблемы. Часть 3: МикроРНК и подходы к лечению сердечно-сосудистых заболеваний</article-title><trans-title-group xml:lang="en"><trans-title>MicroRNA: a clinician’s view of the state of the problem.  Part 3: MicroRNA and approaches to the treatment of cardiovascular diseases</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5820-1759</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Миронова</surname><given-names>О. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Mironova</surname><given-names>O. Iu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Миронова Ольга Юрьевна - доктор медицинских наук, профессор кафедры факультетской терапии №1, Институт клинической медицины им. Н.В. Склифосовского.</p><p>ул. Большая Пироговская, д. 6, стр. 1, Москва 119435</p></bio><bio xml:lang="en"><p>Olga Iu. Mironova - Dr. of Sci. (Med.), Prof., Chair of Faculty Therapy #1, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University).</p><p>Bol. Pirogovskaya st., 6/1, Moscow 119435</p></bio><email xlink:type="simple">mironova_o_yu@staff.sechenov.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3393-6863</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бердышева</surname><given-names>М. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Berdysheva</surname><given-names>M. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Бердышева Мария Валерьевна - студент 5 курса.</p><p>ул. Большая Пироговская, д. 6, стр. 1, Москва 119435</p></bio><bio xml:lang="en"><p>Mariia  V. Berdysheva - student, I.M. Sechenov First Moscow State Medical University (Sechenov University).</p><p>Bol. Pirogovskaya st., 6/1, Moscow 119435</p></bio><email xlink:type="simple">berdyshevaam@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-6761-1744</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Деева</surname><given-names>Е. С.</given-names></name><name name-style="western" xml:lang="en"><surname>Deeva</surname><given-names>E. S.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Деева Екатерина Сергеевна - врач-ординатор.</p><p>ул. Гамалеи, 15, Москва 123098</p></bio><bio xml:lang="en"><p>Ekaterina S. Deeva - resident doctor, A.I. Burnasyan Federal Medical Biophysical Center.</p><p>Gamaleyi st., 15, Moscow 123098</p></bio><email xlink:type="simple">katydeeva@yandex.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-3140-5030</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Елфимова</surname><given-names>Е. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Elfimova</surname><given-names>E. M.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Елфимова Евгения Михайловна - кандидат медицинских наук, старший научный сотрудник лаборатории апноэ сна отдела гипертонии.</p><p>ул. Академика Чазова, д. 15 а, Москва 121552</p><p>тел: 8(495)414-65-43</p></bio><bio xml:lang="en"><p>Eugenia M. Elfimova - Cand. of Sci. (Med.), senior research scientist of the Sleep Laboratory, Hypertension Department, E.I. Chazov National Medical  Research Centre of Cardiology.</p><p>Ac. Chazov Street, 15a, Moscow, 121552</p></bio><email xlink:type="simple">eelfimova@cardio.ru</email><xref ref-type="aff" rid="aff-3"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГАОУ Первый МГМУ им. И.М. Сеченова (Сеченовский Университет) МЗ РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>I.M. Sechenov First Moscow State Medical University (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральный медицинский биофизический центр имени А.И. Бурназяна ФМБА России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>A.I. Burnazyan Federal Medical Biophysical Center</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБУ «НМИЦ Кардиологии имени Академика Е.И. Чазова» МЗ РФ</institution><country>Россия</country></aff><aff xml:lang="en"><institution>E.I. Chazov National Medical Research Center of Cardiology</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2023</year></pub-date><pub-date pub-type="epub"><day>10</day><month>10</month><year>2023</year></pub-date><volume>0</volume><issue>3</issue><fpage>82</fpage><lpage>88</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Миронова О.Ю., Бердышева М.В., Деева Е.С., Елфимова Е.М., 2023</copyright-statement><copyright-year>2023</copyright-year><copyright-holder xml:lang="ru">Миронова О.Ю., Бердышева М.В., Деева Е.С., Елфимова Е.М.</copyright-holder><copyright-holder xml:lang="en">Mironova O.I., Berdysheva M.V., Deeva E.S., Elfimova E.M.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.heartj.asia/jour/article/view/6406">https://www.heartj.asia/jour/article/view/6406</self-uri><abstract><p>Сердечно-сосудистые   заболевания являются одной  из наиболее  частых причин смерти  как в развивающихся,  так и в развитых странах мира. Несмотря на улучшение первичной профилактики, распространенность сердечно-сосудистых  заболеваний в последние годы продолжает расти. Следовательно, крайне важно как глубоко изучить молекулярную патофизиологию сердечно-сосудистых  заболеваний, так и найти новые методы для ранней и надлежащей профилактики, диагностики и лечения данных заболеваний. В последнее  десятилетие большой  объём  исследований направлен на изучение микроРНК в качестве потенциальных диагностических биомаркеров, а также на их роль в лечении сердечно-сосудистых заболеваний. МикроРНК представляют  собой  эндогенные  небольшие  (21-23  нуклеотида) рибонуклеотиды,  участвующие в регуляции процесса  синтеза белка из аминокислот на базе  матричной  РНК. МикроРНК участвуют  в регуляции экспрессии  большинства (&gt;60%)  генов, кодирующих белки, в основном за счет ее подавления, модулируют  многочисленные  сигнальные пути и клеточные процессы  и участвуют в межклеточной коммуникации. Наряду с этим доказана немаловажная роль микроРНК в сердечно-сосудистой  системе: участие в регуляции таких процессов, как ангиогенез,  сократимость клеток сердца, контроль метаболизма  липидов, скорость  развития фиброза и атеросклероза,  что дает возможность  использовать  микроРНК в качестве терапевтических средств.  Так, в статье рассмотрен  вопрос  наличия нескольких  подходов  к лечению с участием  микроРНК: гиперэкспрессия экзогенной  микроРНК для снижения экспрессии  генов с нежелательными свойствами,  гиперэкспрессия  ингибиторов микроРНК, использование «ложных»  микроРНК или «губок»,  которые  действуют  как конкурентные ингибиторы. Также рассмотрено  использование  вирусов с положительной (смысловой) цепью РНК, напоминающие эндогенные мРНК.</p><p>Особое   внимание автора  уделено  важной роли  микроРНК в  ряде  сердечно-сосудистых   заболеваний: продемонстрирована  терапия на основе микроРНК в лечении таких заболеваний,  как сердечная  недостаточность, дислипидемия, острый  коронарный синдром,  артериальная гипертензия, а  также  артериальная  гипертензия,  обусловленная   СОАС. Рассмотрены исследования,  доказывающие  положительное  влияние микроРНК на замедление развития атеросклероза, что может позволить использовать их в качестве новых терапевтических средств,  которые  могут привести к оптимизации подходов к лечению сердечно-сосудистых  заболеваний. Особенно активно ведется разработка препаратов на основе  РНК-интерференции (РНКи), которые используют  недавно открытые пути эндогенных коротких интерферирующих РНК и становятся универсальными инструментами для эффективного  подавления экспрессии белка. Так, использование  некоторых препаратов на основе  РНК-интерференции в ряде клинических исследований показало значительное снижение уровня холестерина-не-ЛПВП и триглицеридов  при лечении дислипидемии  и NT-proBNP при лечении наследственного   транстиретинового  амилоидоза.  В данной статье затронут вопрос такой немаловажной проблемы, как инфаркт миокарда.  Так, гипертрофия и фиброз  сердца в значительной степени способствуют утолщению и повышению жесткости стенок желудочков, приводя к ремоделированию сердца и ухудшая прогноз. С этой целью может использоваться  биосовместимый пластырь с микроиглами (МИ) с антифиброзной активностью на основе  микроРНК для предотвращения чрезмерного  сердечного  фиброза после  инфаркта миокарда. Суммируя вышесказанное, безусловно,  стоит отметить,  что данная проблема  мало изучена и требует  дальнейших исследований. Выявление безопасной  и эффективной  стратегии терапии на основе  микроРНК остается сложной задачей, однако рассмотренные новые подходы обладают огромным потенциалом для лечения сердечно-сосудистых заболеваний.</p></abstract><trans-abstract xml:lang="en"><p>Cardiovascular diseases  are one of the most common  causes of death in both developing and developed countries of the world. Despite the improvement in primary prevention, the prevalence of cardiovascular diseases has continued to grow  in recent years. Therefore, it is extremely important both to study the  molecular  pathophysiology   of cardiovascular   diseases   in  depth  and to find new  methods  for early and appropriate prevention, diagnosis  and treatment of these diseases.  In the last decade,  a large amount of research has focused on the study of microRNAs as potential diagnostic biomarkers, as well as their role in the treatment of cardiovascular diseases. microRNAs are endogenous   small (21-23  nucleotides)  ribonucleotides  involved in the regulation  of protein synthesis  from  amino  acids  based  on matrix  RNA. microRNAs  are involved in the regulation of the expression  of the majority (&gt;60%)  of genes encoding  proteins, mainly due to its suppression, modulate numerous  signaling  pathways and  cellular processes   and  participate in intercellular communication. Along with this, the important role of microRNAs in the cardiovascular system has been proven: participation in the regulation of processes such as angiogenesis, contractility of heart cells, control of lipid metabolism, the rate of fibrosis and atherosclerosis,  which makes it possible to use microRNAs as therapeutic agents. Thus, the article considers  the issue of the availability of several approaches  to treatment involving microRNAs: overexpression of exogenous  microRNAs to reduce the expression of genes with undesirable properties, overexpression  of microRNA inhibitors, the use of «false»  microRNAs or «sponges» that act as competitive  inhibitors. The use of viruses with a positive (semantic)  RNA chain resembling endogenous mRNAs is also considered.</p><p>The author pays special attention to the important role of microRNAs in a number of cardiovascular diseases:  microRNA-based  therapy has been demonstrated in the treatment of diseases  such as heart failure, dyslipidemia, acute coronary syndrome,  arterial hypertension,  as well as arterial hypertension caused  by OSA. Studies proving the positive effect of microRNAs on slowing down the development of atherosclerosis  are considered,  which may allow them to be used as new therapeutic agents that can lead to optimization of approaches  to the treatment of cardiovascular  diseases.  Particularly active is the development of drugs based on RNA interference  (RNAi), which  use  recently discovered pathways of endogenous  short interfering RNAs and become  universal tools for  effective  suppression  of protein  expression.   Thus,  the  use  of certain drugs  based  on RNA interference in a number of clinical studies has shown a significant decrease  in the level of non-HDL cholesterol  and triglycerides in the treatment of dyslipidemia  and NT-proBNP  in the treatment of hereditary transtyretin amyloidosis.   This  article  touches   upon  the  issue  of such  an important problem  as  myocardial  infarction. Thus, hypertrophy and fibrosis of the heart significantly contribute  to thickening and increasing  the rigidity of the ventricular walls, leading to remodeling  of the heart and worsening  the prognosis. For this purpose, a biocompatible patch with microneedles (MI) with antifibrotic activity based on microRNA can be used to prevent excessive  cardiac fibrosis after myocardial infarction. Summarizing the above, it is certainly  worth noting that this problem  has been  little studied and requires  further research. Identifying a safe and effective strategy for microRNA-based therapy remains a difficult task, but the new approaches  considered  have enormous  potential for the treatment of cardiovascular  diseases.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>микроРНК</kwd><kwd>мРНК</kwd><kwd>биомаркер</kwd><kwd>сердечно-сосудистые  заболевания</kwd><kwd>прогноз</kwd><kwd>терапия</kwd></kwd-group><kwd-group xml:lang="en"><kwd>miRNA</kwd><kwd>mRNA</kwd><kwd>biomarker</kwd><kwd>cardiovascular diseases</kwd><kwd>prognosis</kwd><kwd>treatment</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Kennel PJ, Schulze PC. A Review on the Evolving Roles of MiRNA-Based Technologies in Diagnosing and Treating Heart Failure. Cells. 2021 Nov 16;10(11):3191. 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