Established and Emerging Roles of Epigenetic Regulation in Diabetic Cardiomyopathy

Area of Science:

• Cardiovascular Research
• Endocrinology
• Molecular Biology

Background:

• Type 2 diabetes (T2DM) poses significant cardiovascular (CV) risks, including diabetic cardiomyopathy (DCM).
• DCM presents a complex cardiac phenotype with inflammation, fibrosis, and dysfunction, lacking effective treatments due to poorly understood mechanisms.
• Existing research has not fully elucidated the pathogenic pathways driving DCM initiation and progression.

Purpose of the Study:

• To review the role of epigenetic alterations in the development and progression of diabetic cardiomyopathy.
• To discuss cell-specific epigenetic changes in diabetic hearts and their cooperative roles.
• To explore epigenetic biomarkers and novel therapeutic targets for DCM.

Main Methods:

• Literature review focusing on epigenetic mechanisms in DCM.
• Analysis of DNA methylation, histone modifications, BET proteins, and RNA-based mechanisms (miRs, lncRNAs, circRNAs).
• Inclusion of recent advancements in epitranscriptomics related to DCM.

Main Results:

• Epigenetic alterations are significantly associated with DCM initiation and progression, especially in early stages.
• Specific cell types within the diabetic heart exhibit unique epigenetic changes.
• Epigenetic cooperation and biomarkers are implicated in DCM development and progression.

Conclusions:

• Epigenetic modifications are crucial in DCM pathogenesis, offering insights into disease mechanisms.
• Further research into epigenetic alterations and epitranscriptomics may reveal novel therapeutic strategies for DCM.
• Targeting epigenetic pathways holds promise for preventing and treating diabetic cardiomyopathy and its CV complications.