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Cardiomyocyte senescence and the potential therapeutic role of senolytics in the heart 心肌细胞衰老和衰老素对心脏的潜在治疗作用
Pub Date : 2024-06-03 DOI: 10.20517/jca.2024.06
P. Zhai, J. Sadoshima
Cellular senescence in cardiomyocytes, characterized by cell cycle arrest, resistance to apoptosis, and the senescence-associated secretory phenotype, occurs during aging and in response to various stresses, such as hypoxia/reoxygenation, ischemia/reperfusion, myocardial infarction (MI), pressure overload, doxorubicin treatment, angiotensin II, diabetes, and thoracic irradiation. Senescence in the heart has both beneficial and detrimental effects. Premature senescence of myofibroblasts has salutary effects during MI and pressure overload. On the other hand, persistent activation of senescence in cardiomyocytes precipitates cardiac dysfunction and adverse remodeling through paracrine mechanisms during MI, myocardial ischemia/reperfusion, aging, and doxorubicin-induced cardiomyopathy. Given the adverse roles of senescence in many conditions, specific removal of senescent cells, i.e., senolysis, is of great interest. Senolysis can be achieved using senolytic drugs (such as Navitoclax, Dasatinib, and Quercetin), pharmacogenetic approaches (including INK-ATTAC and AP20187, p16-3MR and Ganciclovir, p16 ablation, and p16-LOX-ATTAC and Cre), and immunogenetic interventions (CAR T cells or senolytic vaccination). In order to enhance the specificity and decrease the off-target effects of senolytic approaches, investigation into the mechanisms through which cardiomyocytes develop and/or maintain the senescent state is needed.
心肌细胞的细胞衰老以细胞周期停滞、抗凋亡和衰老相关分泌表型为特征,发生在衰老过程中和各种应激反应中,如缺氧/再氧合、缺血/再灌注、心肌梗死(MI)、压力超负荷、多柔比星治疗、血管紧张素 II、糖尿病和胸部照射。心脏衰老既有好处也有坏处。在心肌梗死和压力超负荷时,肌成纤维细胞的过早衰老具有有益的作用。另一方面,在心肌梗死、心肌缺血/再灌注、衰老和多柔比星诱导的心肌病中,心肌细胞中衰老的持续激活会通过旁分泌机制诱发心脏功能障碍和不良重塑。鉴于衰老在许多情况下的不利作用,特异性清除衰老细胞(即衰老分解)引起了人们的极大兴趣。衰老溶解可通过使用衰老溶解药物(如 Navitoclax、Dasatinib 和 Quercetin)、药物遗传学方法(包括 INK-ATTAC 和 AP20187、p16-3MR 和 Ganciclovir、p16 消融、p16-LOX-ATTAC 和 Cre)以及免疫遗传学干预(CAR T 细胞或衰老溶解疫苗接种)来实现。为了提高溶衰老方法的特异性并减少其脱靶效应,需要对心肌细胞形成和/或维持衰老状态的机制进行研究。
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引用次数: 0
Dysfunctional mitochondria elicit bioenergetic decline in the aged heart. 线粒体功能失调导致老年心脏生物能下降。
Pub Date : 2024-04-01 Epub Date: 2024-02-01 DOI: 10.20517/jca.2023.50
Pasquale Mone, Esther Densu Agyapong, Giampaolo Morciano, Stanislovas S Jankauskas, Antonio De Luca, Fahimeh Varzideh, Paolo Pinton, Gaetano Santulli

Aging represents a complex biological progression affecting the entire body, marked by a gradual decline in tissue function, rendering organs more susceptible to stress and diseases. The human heart holds significant importance in this context, as its aging process poses life-threatening risks. It entails macroscopic morphological shifts and biochemical changes that collectively contribute to diminished cardiac function. Among the numerous pivotal factors in aging, mitochondria play a critical role, intersecting with various molecular pathways and housing several aging-related agents. In this comprehensive review, we provide an updated overview of the functional role of mitochondria in cardiac aging.

衰老是一种影响全身的复杂生理过程,其特点是组织功能逐渐衰退,使器官更容易受到压力和疾病的影响。在这方面,人体心脏具有重要意义,因为它的衰老过程会带来威胁生命的风险。衰老过程会引起宏观形态变化和生化变化,共同导致心脏功能减退。在衰老的众多关键因素中,线粒体起着至关重要的作用,它与各种分子途径交织在一起,并容纳了多种与衰老相关的因子。在这篇综述中,我们对线粒体在心脏衰老中的功能作用进行了最新概述。
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引用次数: 0
Targeting vascular senescence in cardiovascular disease with aging. 针对心血管疾病中的血管衰老与衰老。
Pub Date : 2024-04-01 Epub Date: 2024-02-28 DOI: 10.20517/jca.2023.45
Shelby A Hall, Lisa A Lesniewski

Aging is a major risk factor for atherosclerosis and cardiovascular disease (CVD). Two major age-associated arterial phenotypes, endothelial dysfunction and large elastic arterial stiffness, are autonomous predictors of future CVD diagnosis and contribute to the progression of CVD in older adults. Senescent cells lose the capacity to proliferate but remain metabolically active and secrete inflammatory factors termed senescence-associated secretory phenotype (SASP), leading to an increase in inflammation and oxidative stress. Accumulation of senescent cells is linked with the progression of age-related diseases and has been known to play a role in cardiovascular disease. In this brief review, we describe the characteristics and mechanisms of senescent cell accumulation and how senescent cells promote endothelial dysfunction and arterial stiffness. We focus on a range of novel therapeutic strategies aimed at reducing the burden of endothelial dysfunction leading to atherosclerosis through targeting senescent cells. Studies have begun to investigate a specific class of drugs that are able to selectively eliminate senescent cells, termed senolytics, which have shown great promise in reversing the aging phenotype and ameliorating pathologies in age-related disorders, creating a new opportunity for aging research. Generating therapies targeting the elimination of senescent cells would improve health span and increase longevity, making senolytics a promising therapy for cardiovascular diseases.

衰老是动脉粥样硬化和心血管疾病(CVD)的主要风险因素。两大与年龄相关的动脉表型--内皮功能障碍和大弹性动脉僵硬度--是未来诊断出心血管疾病的自主预测因子,也是导致老年人心血管疾病恶化的原因之一。衰老细胞失去增殖能力,但仍保持新陈代谢活跃,并分泌称为衰老相关分泌表型(SASP)的炎症因子,导致炎症和氧化应激增加。衰老细胞的积累与年龄相关疾病的进展有关,并且已知在心血管疾病中起作用。在这篇简短的综述中,我们描述了衰老细胞积累的特点和机制,以及衰老细胞如何促进内皮功能障碍和动脉僵化。我们将重点关注一系列新型治疗策略,这些策略旨在通过靶向衰老细胞来减轻导致动脉粥样硬化的内皮功能障碍的负担。研究已经开始调查一类能够选择性消除衰老细胞的特定药物,这种药物被称为衰老溶解剂,在逆转衰老表型和改善老年相关疾病的病理方面显示出巨大的前景,为衰老研究创造了新的机遇。产生以消除衰老细胞为目标的疗法将改善健康寿命和延长寿命,使衰老素成为一种治疗心血管疾病的有前途的疗法。
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引用次数: 0
The role of brown adipose tissue in mediating healthful longevity. 棕色脂肪组织在调解健康长寿中的作用。
Pub Date : 2024-04-01 Epub Date: 2024-04-27 DOI: 10.20517/jca.2024.01
Jie Zhang, Berhanu Geresu Kibret, Dorothy E Vatner, Stephen F Vatner

There are two major subtypes of adipose tissue, i.e., white adipose tissue (WAT) and brown adipose tissue (BAT). It has been known for a long time that WAT mediates obesity and impairs healthful longevity. More recently, interest has focused on BAT, which, unlike WAT, actually augments healthful aging. The goal of this review is to examine the role of BAT in mediating healthful longevity. A major role for BAT and its related beige adipose tissue is thermogenesis, as a mechanism to maintain body temperature by producing heat through uncoupling protein 1 (UCP1) or through UCP1-independent thermogenic pathways. Our hypothesis is that healthful longevity is, in part, mediated by BAT. BAT protects against the major causes of impaired healthful longevity, i.e., obesity, diabetes, cardiovascular disorders, cancer, Alzheimer's disease, reduced exercise tolerance, and impaired blood flow. Several genetically engineered mouse models have shown that BAT enhances healthful aging and that their BAT is more potent than wild-type (WT) BAT. For example, when BAT, which increases longevity and exercise performance in mice with disruption of the regulator of G protein signaling 14 (RGS14), is transplanted to WT mice, their exercise capacity is enhanced at 3 days after BAT transplantation, whereas BAT transplantation from WT to WT mice also resulted in increased exercise performance, but only at 8 weeks after transplantation. In view of the ability of BAT to mediate healthful longevity, it is likely that a pharmaceutical analog of BAT will become a novel therapeutic modality.

脂肪组织有两大亚型,即白色脂肪组织(WAT)和棕色脂肪组织(BAT)。人们很早就知道,白色脂肪组织会导致肥胖并影响健康长寿。最近,人们开始关注棕色脂肪组织,因为它与脂肪组织不同,实际上能促进健康长寿。本综述旨在研究 BAT 在介导健康长寿方面的作用。BAT及其相关米色脂肪组织的一个主要作用是产热,这是一种通过解偶联蛋白1(UCP1)或不依赖于UCP1的产热途径产生热量来维持体温的机制。我们的假设是,健康长寿在一定程度上是由脂肪组织介导的。BAT可防止健康长寿受损的主要原因,即肥胖、糖尿病、心血管疾病、癌症、老年痴呆症、运动耐受力下降和血流受损。几种基因工程小鼠模型表明,BAT 能促进健康老化,而且它们的 BAT 比野生型(WT)BAT 更有效。例如,G 蛋白信号转导调节因子 14(RGS14)中断的小鼠的 BAT 可增加其寿命和运动能力,将 BAT 移植给 WT 小鼠时,它们的运动能力在 BAT 移植后 3 天就得到了提高,而将 BAT 从 WT 移植给 WT 小鼠也可提高运动能力,但要在移植后 8 周才能提高。鉴于 BAT 能够介导健康长寿,BAT 的药物类似物很可能成为一种新的治疗方式。
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引用次数: 0
From vitality to vulnerability: the impact of oxygen on cardiac function and regeneration 从活力到脆弱:氧气对心脏功能和再生的影响
Pub Date : 2024-02-22 DOI: 10.20517/jca.2024.05
Dogacan Yucel, William T. Pu
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引用次数: 0
Circulating culprit or therapeutic bullseye: lipoprotein(a) in cardiovascular risk assessment and novel therapeutic prospects 循环罪魁祸首还是治疗靶心:心血管风险评估中的脂蛋白(a)和新的治疗前景
Pub Date : 2024-01-17 DOI: 10.20517/jca.2023.35
A. Cesaro, Gianmaria Scherillo, G. De Michele, V. Acerbo, G. Signore, Domenico Panico, Gennaro Porcelli, F. Scialla, Giuseppe Raucci, Francesco Paolo Rotolo, Marco Tontodonato, Antonio De Pasquale, Andrea Vergara, Danilo Lisi, M. Mensorio, F. Fimiani, P. Calabrò
Lipoprotein(a) [Lp(a)] has emerged as a significant player in the realm of cardiovascular disease (CVD), exerting a pivotal role in atherosclerotic cardiovascular disease (ASCVD), aortic valve stenosis (AVS), and overall cardiovascular (CV) and all-cause mortality. Since its discovery in 1963 by Kåre Berg, our understanding of Lp(a) has undergone significant evolution. This comprehensive review delves into the genetics, structure, assembly, and inter-population differences of Lp(a), shedding light on its intricate involvement in CVD. Genetically, Lp(a) is primarily influenced by variations in the LPA gene. The LPA gene encodes apo(a) and the variation in the kringle domains is the main determinant of plasma Lp(a) levels. Other genetic variants, such as SNPs in the LPA gene region, the pentanucleotide repeat polymorphism, and specific SNPs in the coding sequences of kringle domains, have also been associated with varying Lp(a) concentrations. Additionally, genes outside the LPA locus, including APOE, APOH, and CEPT gene regions, contribute to Lp(a) variability across different populations. Inter-population differences in Lp(a) levels are evident, with ethnicity and sex playing significant roles. Racial disparities in median Lp(a) concentration have been observed, with black individuals often displaying higher levels compared to their white counterparts. The review underscores Lp(a) as an independent, heritable CV risk factor in both primary and secondary settings. High Lp(a) levels are closely linked to the recurrence of myocardial infarction, AVS, and CV events. The necessity of measuring Lp(a) concentration at least once in life to assess an individual's absolute global CV risk is emphasized. Despite substantial progress, many questions remain unanswered about Lp(a), including its physiological role in the cardiovascular system and its involvement in inflammatory and thrombotic processes. Ongoing research holds promise for the development of therapeutic interventions, such as pharmacological agents and apheresis, to mitigate the cardiovascular risks associated with elevated Lp(a) levels. This review highlights the multifaceted nature of Lp(a) in the context of cardiovascular health, emphasizing the importance of continued research efforts to unravel its complexities and develop innovative strategies for managing its associated risks.
脂蛋白(a)[Lp(a)]已成为心血管疾病(CVD)领域的重要角色,在动脉粥样硬化性心血管疾病(ASCVD)、主动脉瓣狭窄(AVS)、心血管疾病(CV)总死亡率和全因死亡率中发挥着举足轻重的作用。自1963年Kåre Berg发现脂蛋白(a)以来,我们对脂蛋白(a)的认识经历了重大的演变。本综述深入探讨了脂蛋白(a)的遗传、结构、组装和人群间差异,揭示了脂蛋白(a)与心血管疾病的复杂关系。从遗传学角度看,脂蛋白(a)主要受 LPA 基因变异的影响。LPA 基因编码载脂蛋白(a),其环状结构域的变异是决定血浆载脂蛋白(a)水平的主要因素。其他基因变异,如 LPA 基因区域的 SNPs、五核苷酸重复多态性和 kringle 结构域编码序列中的特定 SNPs,也与 Lp(a) 浓度的变化有关。此外,LPA 基因座以外的基因,包括 APOE、APOH 和 CEPT 基因区域,也会导致不同人群的脂蛋白(a)差异。人群间脂蛋白(a)水平差异明显,其中种族和性别起着重要作用。据观察,脂蛋白(a)浓度中位数存在种族差异,黑人的脂蛋白(a)浓度往往高于白人。综述强调,脂蛋白(a)是原发性和继发性冠心病的独立遗传风险因素。高脂蛋白(a)水平与心肌梗死、心房颤动和心血管事件的复发密切相关。人们强调,必须在一生中至少测量一次脂蛋白(a)浓度,以评估个人的绝对总体心血管风险。尽管取得了重大进展,但有关脂蛋白(a)的许多问题仍未得到解答,包括其在心血管系统中的生理作用及其在炎症和血栓形成过程中的参与。正在进行的研究有望开发出治疗干预措施,如药理制剂和血液透析,以减轻脂蛋白(a)水平升高带来的心血管风险。这篇综述强调了脂蛋白(a)在心血管健康方面的多面性,强调了继续开展研究工作以揭示其复杂性并开发创新战略以控制其相关风险的重要性。
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引用次数: 0
Hypertrophic cardiomyopathy in MYBPC3 carriers in aging 老龄化过程中 MYBPC3 携带者的肥厚型心肌病
Pub Date : 2024-01-11 DOI: 10.20517/jca.2023.29
Kalyani Ananthamohan, Julian E. Stelzer, S. Sadayappan
Hypertrophic cardiomyopathy (HCM) is characterized by abnormal thickening of the myocardium, leading to arrhythmias, heart failure, and elevated risk of sudden cardiac death, particularly among the young. This inherited disease is predominantly caused by mutations in sarcomeric genes, among which those in the cardiac myosin binding protein-C3 (MYBPC3 ) gene are major contributors. HCM associated with MYBPC3 mutations usually presents in the elderly and ranges from asymptomatic to symptomatic forms, affecting numerous cardiac functions and presenting significant health risks with a spectrum of clinical manifestations. Regulation of MYBPC3 expression involves various transcriptional and translational mechanisms, yet the destiny of mutant MYBPC3 mRNA and protein in late-onset HCM remains unclear. Pathogenesis related to MYBPC3 mutations includes nonsense-mediated decay, alternative splicing, and ubiquitin-proteasome system events, leading to allelic imbalance and haploinsufficiency. Aging further exacerbates the severity of HCM in carriers of MYBPC3 mutations. Advancements in high-throughput omics techniques have identified crucial molecular events and regulatory disruptions in cardiomyocytes expressing MYBPC3 variants. This review assesses the pathogenic mechanisms that promote late-onset HCM through the lens of transcriptional, post-transcriptional, and post-translational modulation of MYBPC3 , underscoring its significance in HCM across carriers. The review also evaluates the influence of aging on these processes and MYBPC3 levels during HCM pathogenesis in the elderly. While pinpointing targets for novel medical interventions to conserve cardiac function remains challenging, the emergence of personalized omics offers promising avenues for future HCM treatments, particularly for late-onset cases.
肥厚型心肌病(HCM)的特征是心肌异常增厚,导致心律失常、心力衰竭和心源性猝死风险升高,尤其是在年轻人中。这种遗传性疾病主要是由肌纤维基因突变引起的,其中心脏肌球蛋白结合蛋白-C3(MYBPC3)基因突变是主要原因。与 MYBPC3 基因突变相关的 HCM 通常发生在老年人身上,从无症状到有症状不等,影响多种心脏功能,临床表现多种多样,对健康构成重大威胁。MYBPC3 表达的调控涉及各种转录和翻译机制,但突变 MYBPC3 mRNA 和蛋白在晚发型 HCM 中的命运仍不清楚。与 MYBPC3 突变有关的发病机制包括无义介导的衰变、替代剪接和泛素-蛋白酶体系统事件,从而导致等位基因失衡和单倍体不足。衰老会进一步加剧 MYBPC3 突变携带者 HCM 的严重程度。高通量全息技术的进步已确定了表达 MYBPC3 变异的心肌细胞中的关键分子事件和调控紊乱。本综述从 MYBPC3 的转录、转录后和翻译后调节的角度评估了促进晚发型 HCM 的致病机制,强调了其在不同携带者的 HCM 中的重要性。综述还评估了衰老对这些过程的影响以及老年人 HCM 发病过程中的 MYBPC3 水平。虽然为保护心脏功能的新型医疗干预措施确定靶点仍具有挑战性,但个性化分子生物学的出现为未来的 HCM 治疗,尤其是晚发性病例的治疗提供了前景广阔的途径。
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引用次数: 0
Long-term efficacy and safety of cardiac genome editing for catecholaminergic polymorphic ventricular tachycardia 心脏基因组编辑治疗儿茶酚胺能多态性室性心动过速的长期疗效和安全性
Pub Date : 2024-01-05 DOI: 10.20517/jca.2023.42
Oliver M. Moore, Yuriana Aguilar-Sánchez, S. Lahiri, M. Hulsurkar, J. Navarro-García, Tarah A. Word, Joshua A. Keefe, Dean Barazi, Elda M. Munivez, Charles T. Moore, Vaidya Parthasarathy, Jaysón M. Davidson, William R. Lagor, So Hyun Park, Gang Bao, Christina Y. Miyake, X.H.T. Wehrens
Introduction: Heterozygous autosomal-dominant single nucleotide variants in RYR2 account for 60% of cases of catecholaminergic polymorphic ventricular tachycardia (CPVT), an inherited arrhythmia disorder associated with high mortality rates. CRISPR/Cas9-mediated genome editing is a promising therapeutic approach that can permanently cure the disease by removing the mutant RYR2 allele. However, the safety and long-term efficacy of this strategy have not been established in a relevant disease model. Aim: The purpose of this study was to assess whether adeno-associated virus type-9 (AAV9)-mediated somatic genome editing could prevent ventricular arrhythmias by removal of the mutant allele in mice that are heterozygous for Ryr2 variant p.Arg176Gln (R176Q/+). Methods and Results: Guide RNA and SaCas9 were delivered using AAV9 vectors injected subcutaneously in 10-day -old mice. At 6 weeks after injection, R176Q/+ mice had a 100% reduction in ventricular arrhythmias compared to controls. When aged to 12 months, injected R176Q/+ mice maintained a 100% reduction in arrhythmia induction. Deep RNA sequencing revealed the formation of insertions/deletions at the target site with minimal off-target editing on the wild-type allele. Consequently, CRISPR/SaCas9 editing resulted in a 45% reduction of total Ryr2 mRNA and a 38% reduction in RyR2 protein. Genome editing was well tolerated based on serial echocardiography, revealing unaltered cardiac function and structure up to 12 months after AAV9 injection. Conclusion: Taken together, AAV9-mediated CRISPR/Cas9 genome editing could efficiently disrupt the mutant Ryr2 allele, preventing lethal arrhythmias while preserving normal cardiac function in the R176Q/+ mouse model of CPVT.
导言:儿茶酚胺能多形性室性心动过速(CPVT)是一种遗传性心律失常疾病,死亡率很高,RYR2 的杂合子常染色体显性单核苷酸变异占 CPVT 病例的 60%。CRISPR/Cas9 介导的基因组编辑是一种很有前景的治疗方法,它可以通过去除突变的 RYR2 等位基因永久治愈这种疾病。然而,这一策略的安全性和长期疗效尚未在相关疾病模型中得到证实。目的:本研究的目的是评估腺相关病毒 9 型(AAV9)介导的体细胞基因组编辑是否能通过去除 Ryr2 变异 p.Arg176Gln (R176Q/+)杂合子小鼠的突变等位基因来预防室性心律失常。方法和结果:使用 AAV9 载体向出生 10 天的小鼠皮下注射引导 RNA 和 SaCas9。注射 6 周后,与对照组相比,R176Q/+ 小鼠的室性心律失常减少了 100%。到 12 个月大时,注射 R176Q/+ 的小鼠的心律失常诱发率仍保持 100%的下降率。深度 RNA 测序显示,在野生型等位基因的目标位点形成了插入/缺失,而脱靶编辑极少。因此,CRISPR/SaCas9 编辑导致 Ryr2 mRNA 总量减少 45%,RyR2 蛋白减少 38%。序列超声心动图显示,基因组编辑的耐受性良好,AAV9 注射后 12 个月内心脏功能和结构未发生改变。结论综上所述,AAV9 介导的 CRISPR/Cas9 基因组编辑可以有效地破坏突变的 Ryr2 等位基因,在 R176Q/+ CPVT 小鼠模型中防止致命性心律失常,同时保留正常的心脏功能。
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引用次数: 0
Regulators of clonal hematopoiesis and physiological consequences of this condition 克隆造血的调节因子及其生理后果
Pub Date : 2024-01-01 DOI: 10.20517/jca.2023.39
E. Park, Megan A. Evans, Kenneth Walsh
Clonal hematopoiesis (CH) is a prevalent condition that results from somatic mutations in hematopoietic stem cells. When these mutations occur in “driver” genes, they can potentially confer fitness advantages to the affected cells, leading to a clonal expansion. While most clonal expansions of mutant cells are generally considered to be asymptomatic since they do not impact overall blood cell numbers, CH carriers face long-term risks of all-cause mortality and age-associated diseases, including cardiovascular disease and hematological malignancies. While considerable research has focused on understanding the association between CH and these diseases, less attention has been given to exploring the regulatory factors that contribute to the expansion of the driver gene clone. This review focuses on the association between environmental stressors and inherited genetic risk factors in the context of CH development. A better understanding of how these stressors impact CH development will facilitate mechanistic studies and potentially lead to new therapeutic avenues to treat individuals with this condition.
克隆性造血(CH)是造血干细胞体细胞突变导致的一种普遍情况。当这些突变发生在 "驱动 "基因中时,有可能给受影响的细胞带来适应优势,导致克隆扩增。虽然大多数突变细胞的克隆扩增通常被认为是无症状的,因为它们不会影响整体血细胞数量,但CH携带者面临着全因死亡和与年龄相关疾病的长期风险,包括心血管疾病和血液恶性肿瘤。虽然大量研究都集中在了解 CH 与这些疾病之间的关系上,但较少关注导致驱动基因克隆扩增的调控因素。本综述将重点关注环境压力因素和遗传风险因素在 CH 发展过程中的关联。更好地了解这些压力因素是如何影响 CH 发育的,将有助于进行机理研究,并有可能找到新的治疗途径来治疗这种疾病。
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引用次数: 0
Turning back time: effects of young plasma on pan epigenetic clocks and implications for the heart 时光倒流:年轻血浆对泛表观遗传时钟的影响及其对心脏的意义
Pub Date : 2024-01-01 DOI: 10.20517/jca.2023.44
Kathleen C. Woulfe, Emma L. Robinson
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引用次数: 0
期刊
The journal of cardiovascular aging
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