Inflammatory signalling pathways and non-coding RNAs in myocardial infarction: insights into pathogenesis and therapeutic opportunities.

BACKGROUND: Acute myocardial infarction (AMI) is a major contributor to both morbidity and mortality, resulting from the abrupt blockage of a coronary artery. Myocardial reperfusion refers to the re-establishment of coronary bloodflow following a period of coronary occlusion, which may provoke an intensified and rapid injury to the myocardium, known as ischaemia-reperfusion (I/R) injury. Inflammation is a key feature of myocardial infarction (MI) and I/R injury, playing a central role among the pathological mechanisms involved in AMI and MI/R injury. Non-coding RNAs (ncRNAs), such as microRNAs (miRNAs), long non-coding RNAs (lncRNAs), and circular RNAs (circRNAs), constitute a significant portion of the transcribed genome, with their essential roles and potential in regulating and resolving inflammation now well established. Abnormal ncRNA expression has been linked to worsening inflammatory processes and plays a role in the pathogenesis of MI and MI/R injury.

AIM OF REVIEW AND CONCLUSIONS: This study emphasises the essential roles of miRNAs and competitive endogenous RNAs (ceRNAs) in the progression of MI and MI/R. In addition, our final section provides an in-depth analysis of the therapeutic targeting of ncRNAs through various methods, including pharmacological interventions, herbal medicine, and exosome-derived stem cell applications aimed at alleviating inflammation and possibly advancing MI treatment.