MicroRNAs have an immunomodulatory role in diabetes mellitus and diabetic cardiomyopathy

Abstract

Diabetic cardiomyopathy (DCM), an independent diabetes complication, is characterized by abnormalities in myocardial structure, function, and metabolism, including diminished myocardial contractility, myocardial hypertrophy, and fibrosis. Factors such as hyperglycemia, metabolic disorders, microangiopathy, inflammation, oxidative stress, and insulin resistance have been found to play important roles in DCM pathophysiology. Recent research has shown that miRNAs are involved in processes such as myocardial cell proliferation, differentiation, and metastasis, and promote the progression of DCM. Despite these insights, the regulatory effects of miRNAs on immune function in DCM remain inadequately explored. This review synthesizes current advancements in understanding miRNA-mediated immune regulation in DCM. We highlight the need for further research to elucidate the complex interactions between miRNAs and immune pathways in DCM, which might reveal novel therapeutic targets to mitigate this debilitating condition. Targeted regulation of B cells, macrophages, and T cells through immune-associated miRNAs in DCM might open new avenues for therapeutic intervention. Developing efficient delivery systems for miRNA-based therapies might ensure targeted delivery and enhance stability. Additionally, combining existing hypoglycemic drugs with targeted therapies might produce anti-inflammatory and anti-fibrotic effects, thereby improving therapeutic outcomes. Graphical abstract: [Figure not available: see fulltext.]