TY - JOUR A1 - Laina, Ageliki A1 - Gatsiou, Aikaterini A1 - Georgiopoulos, Georgios A1 - Stamatelopoulos, Kimon A1 - Stellos, Konstantinos T1 - RNA therapeutics in cardiovascular precision medicine T2 - Frontiers in physiology N2 - 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. KW - cardiovascular precision medicine KW - RNA therapy KW - antisense oligonucleotides KW - ASO KW - silence interfering RNA KW - siRNA KW - aptamer KW - microRNA Y1 - 2018 UR - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/51536 UR - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-515361 N1 - Copyright © 2018 Laina, Gatsiou, Georgiopoulos, Stamatelopoulos and Stellos. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) http://creativecommons.org/licenses/by/4.0/ . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. VL - 9 IS - art. 953 PB - Frontiers Research Foundation CY - Lausanne ER -