Author + information
- aDepartment of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, Taoyuan City, Taiwan
- bInstitute of Cellular and System Medicine, National Health Research Institutes, Zhunan, Taiwan
- ↵∗Address for correspondence:
Dr. Chao-Yung Wang, Department of Cardiology, Chang Gung Memorial Hospital, and Chang Gung University College of Medicine, 5 Fu-Hsing Street, Taoyuan 333, Taiwan.
• Age-associated CVDs impose a great burden on current health systems. Despite the fact that current strong evidence supports the links among aging, telomere attrition, and CVDs, there is no clear direction for the development of telomere therapeutics against CVDs.
• This review focuses on immune modulation, CHIP, pharmaceutical interventions, and gene therapy for their therapeutic roles in age-associated CVDs.
• The future goal of telomere cardiovascular therapy in young subjects is to prevent senescence and diseases, whereas in older adult subjects, the goal is restoration of cardiovascular functions. Further studies on the telomere-CHIP-atherosclerosis axis may shed insights on how to achieve these 2 different therapeutic targets.
Telomeres are double-stranded repeats of G-rich tandem DNA sequences that gradually shorten with each cell division. Aging, inflammation, and oxidative stress accelerate the process of telomere shortening. Telomerase counteracts this process by maintaining and elongating the telomere length. Patients with atherosclerotic diseases and cardiovascular risk factors (e.g., smoking, obesity, sedentary lifestyle, and hypertension) have shorter leukocyte telomere length. Following myocardial infarction, telomerase expression and activity in cardiomyocytes and endothelial cells increase significantly, implying that telomerase plays a role in regulating tissue repairs in heart diseases. Although previous studies have focused on the changes of telomeres in heart diseases and the telomere length as a marker for aging cardiovascular systems, recent studies have explored the potential of telomeres and telomerase in the treatment of cardiovascular diseases. This review discusses the significant advancements of telomere therapeutics in gene therapy, atherosclerosis, anti-inflammation, and immune modulation in patients with cardiovascular diseases.
Dr. Wang was supported by the National Health Research Institute (NHRI-EX106-10617SI), National Science Council (105-2628-B-182-009-MY4), and Chang Gung Memorial Hospital (CMRPG3H0132, CMRPG3I0321, and CMRPG3H0842). All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Basic to Translational Science author instructions page.
- Received March 7, 2019.
- Revision received May 27, 2019.
- Accepted May 28, 2019.
- 2019 The Authors
- Central Illustration
- Telomeres and Telomerase
- Gene Therapy With Telomere and Telomerase for CVDs
- Pharmaceutical Interventions for Telomeres and Telomerase Activity
- Inflammation, Atherosclerosis, and Clonal Hematopoiesis of Indeterminate Potential
- Immune Modulation
- Aging Cardiovascular Patients and Telomere Therpay
- Telomere Therapy From the Bench to the Bedside