文献类型：期刊文献

英文题名：miRNA regulatory networks as precision diagnostic and therapeutic targets in pulmonary arterial hypertension: from molecular cascades to clinical translation

作者：Li, Zhaoyu[1];Ding, Hongyang[2];Liu, Xuehai[3];Wang, Di[4];Zhang, Haolong[5];Zhao, Rui[3];Zhang, Haoling[4];Song, Zhijing[3];Wang, Wei[1];Zhang, Jingjing[2]

第一作者：Li, Zhaoyu

通信作者：Wang, W[1];Zhang, JJ[2];Song, ZJ[3];Zhang, HL[4]

机构：[1]Gansu Univ Chinese Med, Coll Acupuncture Moxibust & Tuina, Lanzhou 730000, Gansu, Peoples R China;[2]Chinese Acad Med Sci, Fuwai Yunnan Hosp, Kunming 650000, Yunnan, Peoples R China;[3]Gansu Univ Chinese Med, Clin Coll Tradit Chinese Med, Lanzhou 730000, Gansu, Peoples R China;[4]Univ Sains Malaysia, Adv Med & Dent Inst, Dept Biomed Sci, George Town 13200, Malaysia;[5]Henan Med Univ, Affiliated Hosp 1, Xinxiang 453000, Henan, Peoples R China

第一机构：甘肃中医药大学针灸推拿学院

通信机构：[1]corresponding author), Gansu Univ Chinese Med, Coll Acupuncture Moxibust & Tuina, Lanzhou 730000, Gansu, Peoples R China;[2]corresponding author), Chinese Acad Med Sci, Fuwai Yunnan Hosp, Kunming 650000, Yunnan, Peoples R China;[3]corresponding author), Gansu Univ Chinese Med, Clin Coll Tradit Chinese Med, Lanzhou 730000, Gansu, Peoples R China;[4]corresponding author), Univ Sains Malaysia, Adv Med & Dent Inst, Dept Biomed Sci, George Town 13200, Malaysia.|[10735ccd4a8840d96ab71]甘肃中医药大学中医临床学院;[10735]甘肃中医药大学;[10735db5df93766a96e5b]甘肃中医药大学针灸推拿学院;

年份：2025

卷号：15

期号：6

起止页码：335

外文期刊名：AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE

收录：WOS:【ESCI(收录号:WOS:001655727000001)】；

基金：This work was supported by the Science and Technology Department of Yunnan Province-Kunming Medical University, Kunming Medical joint special project-surface project, China, No. 202401AY070001-164; and Yunnan Provincial Department of Science and Technology Science and Technology Plan Project-Major Science and Technology Special Projects, China, No. 202405AJ310003.

语种：英文

外文关键词：Pulmonary arterial hypertension; microRNA regulatory network; precision diagnosis and therapy; molecular cascade; non-invasive biomarker; nucleic acid drug; clinical translation

摘要：Pulmonary arterial hypertension (PAH) is a fatal disease with extremely poor prognosis, primarily driven by persistent pulmonary vascular remodeling. The disease often presents insidiously and progresses rapidly. Although current targeted therapies may slow disease progression, they fall far short of reversing pathological changes, underscoring the urgent need for novel therapeutic breakthroughs and precise diagnostic approaches. Within this context, microRNA (miRNA) regulatory networks - key nodes of epigenetic regulation - have emerged as a potential bridge between basic science and clinical translation. Increasing evidence has shown that specific miRNAs, by targeting signaling pathways such as PI3K/AKT and TGF-beta/Smad, orchestrate complex multi-target molecular cascades that critically regulate pathological processes, including endothelial dysfunction, abnormal proliferation and phenotypic switching of smooth muscle cells, inflammatory activation, and metabolic remodeling. These mechanisms ultimately drive irreversible vascular remodeling. Aberrant expression patterns of miRNAs are not only closely associated with disease severity but also hold great promise as non-invasive biomarkers, facilitating early detection, subtype classification, and prognostic assessment of PAH. Importantly, miRNA-targeted nucleic acid therapeutics have demonstrated therapeutic potential in preclinical models, including reversal of vascular remodeling and improvement of hemodynamics, highlighting their potential in future precision medicine strategies. However, clinical translation faces multiple barriers, such as poor targeting efficiency of delivery systems, unpredictable off-target effects, significant inter-individual variability, and lack of standardized efficacy evaluation frameworks. Therefore, systematic breakthroughs are urgently needed. This review aims to comprehensively summarize the role of miRNA regulatory networks in the pathogenesis, diagnosis, and treatment of PAH, with a particular emphasis on their central position in shaping early-stage precision intervention strategies.