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Circulating non-coding RNAs in biomarker-guided cardiovascular therapy: A novel tool for personalized medicine?

AuthorsGonzalo-Calvo, David de; Vea, Ángela; Bär, Christian; Fiedler, Jan; Couch, Liam S.; Brotons, Carlos; Llorente-Cortés, Vicenta; Thum, Thomas
Cardiovascular disease
Long non-coding RNAs
Non-coding RNAs
Personalized medicine
Precision medicine
Issue Date21-May-2019
PublisherOxford University Press
CitationEuropean Heart Journal 40(20): 1643-1650 (2019)
AbstractCurrent clinical guidelines emphasize the unmet need for technological innovations to guide physician decision-making and to transit from conventional care to personalized cardiovascular medicine. Biomarker-guided cardiovascular therapy represents an interesting approach to inform tailored treatment selection and monitor ongoing efficacy. However, results from previous publications cast some doubts about the clinical applicability of biomarkers to direct individualized treatment. In recent years, the non-coding human transcriptome has emerged as a new opportunity for the development of novel therapeutic strategies and biomarker discovery. Non-coding RNA (ncRNA) signatures may provide an accurate molecular fingerprint of patient phenotypes and capture levels of information that could complement traditional markers and established clinical variables. Importantly, ncRNAs have been identified in body fluids and their concentrations change with physiology and pathology, thus representing promising non-invasive biomarkers. Previous publications highlight the translational applicability of circulating ncRNAs for diagnosis and prognostic stratification within cardiology. Numerous independent studies have also evaluated the potential of the circulating non-coding transcriptome to predict and monitor response to cardiovascular treatment. However, this field has not been reviewed in detail. Here, we discuss the state-of-the-art research into circulating ncRNAs, specifically microRNAs and long non-coding RNAs, to support clinical decision-making in cardiovascular therapy. Furthermore, we summarize current methodological and conceptual limitations and propose future steps for their incorporation into personalized cardiology. Despite the lack of robust population-based studies and technical barriers, circulating ncRNAs emerge as a promising tool for biomarker-guided therapy.
Publisher version (URL)http://dx.doi.org/10.1093/eurheartj/ehy234
Identifiersdoi: 10.1093/eurheartj/ehy234
e-issn: 1522-9645
issn: 0195-668X
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