Advances in BRD proteins in cardiovascular pathophysiology and therapy: A review

Epigenetic regulation has recently emerged as a central mechanism in the pathogenesis of cardiovascular diseases (CVDs). At the heart of this regulation lies the bromodomain (an evolutionarily conserved protein module that specifically recognizes acetylated lysine residues on histones). As transcriptional coactivators, bromodomain-containing proteins (BRDs) translate these epigenetic marks into changes in gene expression, thereby mediating cellular responses to pathological stimuli. Importantly, BRDs serve as key epigenetic readers that bridge histone acetylation to transcriptional reprogramming in cardiovascular cells, and have emerged as crucial regulators of gene expression and cellular processes underlying cardiovascular health and disease. This review elucidates the multifaceted roles of BRD proteins in orchestrating key pathological processes in CVDs, including vascular inflammation, endothelial dysfunction, phenotypic modulation of vascular smooth muscle cells (VSMCs), cardiomyocyte apoptosis, and fibrosis. Moreover, this study delves into the underlying mechanisms through which BRD proteins influence diverse cardiovascular conditions and highlights their potential clinical applications. By targeting BRD proteins, novel therapeutic strategies can be developed to mitigate CVDs progression, offering new avenues for diagnosis and treatment.