Is Targeting microRNAs the Philosopher's Stone for Vascular Disease?

MicroRNAs (miRs) are small non-coding regulatory RNAs that control gene expression. They are involved in the pathogenesis of several diseases, including vascular and cardiac diseases. Their involvement is related to alterations of lipid metabolism, endothelial dysfunction, vascular smooth muscle cell phenotype, atherosclerosis-related low-grade inflammation of the arteries, cardiac hypertrophy or remodelling and heart failure. The manipulation of miRs may eventually be used to prevent or treat vascular or cardiac disease. Available drugs (some statins and renin-angiotensin-system inhibitors, alone or in combination) have beneficial off-target effects mediated through miRs; thus, these drugs may have advantages over other regimens. Inhibition of overexpression of "unfavourable" miRs can be potentially accomplished by silencing them with antisense oligonucleotides, masking, sponges, erasers or decoys. In contrast, down-regulation of "protective" miRs can be tackled by the administration of miR mimics. These approaches may represent a new therapeutic approach to vascular disease; miR manipulation research started recently and is developing rapidly. There is still a long way to go before clinical implementation; at present only one study is in phase II. Thus, the therapeutic manipulation of miRs is not yet the philosopher stone for the prevention or treatment of vascular or cardiac diseases. More research is needed.