心力衰竭治疗药物的表观遗传药理学进展

Advances in drugs and genetic pharmacology for heart failure

心力衰竭(heart failure,HF)是心室收缩和(或)舒张功能发生障碍的一种疾病,又称心功能不全,可由多种因素引起,主要表现为心脏结构和功能的异常改变,并以交感神经、肾素-血管紧张素-醛固酮等系统激活为特征。通过临床观察,心衰患者在药物治疗期间存在极大异质性,因此在实际用药时,除了要考虑一般的环境因素,还要顾及遗传背景,尤其是序列不改变的表观遗传学。目前,有报道认为心衰患者的用药反应和DNA甲基化、组蛋白修饰、microRNA等修饰相关,但涉及该领域的研究还不多见,因此本文就近几年心衰治疗药物的表观遗传药理学进展进行一个较为全面的综述。

Heart failure(HF)is called cardiac insufficiency and mainly manifested in abnormal changes in cardiac structure and function such as ventricular systolic and(or)diastolic dysfunction,characteristic of sympathetic nerve and renin-angiotensin-aldosterone system activation.Clinical observation has showed that there was great heterogeneity in patients with HF during drug treatment.Therefore,we should take into account not only environmental factors but also genetic ones in terms of drug use,especially the epigenetics.Recently,some reports admited that the drug response of patients with HF was partly related to epigenetic modifications such as DNA methylation,histone modifications and microRNAs.But the relevant research is still rare as yet.Therefore,this article reviews the advances of epigenetic pharmacology in the treatment of HF in recent years.