Tubulin Post-Translational Modifications in Cardiovascular Diseases: Emerging Mechanisms and Therapeutic Modulation...

Cardiovascular diseases (CVDs) severely threaten human health, and microtubule dysfunction is one of the major contributing factors. Tubulin post-translational modifications (PTMs), such as detyrosination, acetylation, and polyglutamylation, regulate microtubule homeostasis, among which the upregulation of detyrosination is a key feature of cardiovascular diseases. Traditional Chinese Medicine (TCM) can alleviate cardiac pathologies by targeting these modifications. This review discusses the driving mechanisms of PTMs in relation to the pathological changes that occur in CVDs and summarizes the therapeutic effects of traditional Chinese Medicine targeting these modifications that have been identified in recent years. By systematically searching databases such as PubMed, it was found that PTMs primarily control the stability and contractility of the microtubule cytoskeleton in cardiomyocytes. Their dysregulation promotes the progression of diseases such as myocardial infarction (MI), atherosclerosis (AS), arrhythmias, and cardiac hypertrophy by disrupting key processes including mitochondrial energy metabolism, inflammasome activation, calcium homeostasis, and oxidative stress (OS). Certain active compounds found in TCM, such as curdione, evodiamine, and tanshinone IIA (Tan-IIA), can modulate PTMs through the synergistic regulation of multiple pathways. This review provides a theoretical basis for establishing TCM-based therapeutic strategies for CVDs that target PTMs.