Modified mRNA as a Treatment for Myocardial Infarction

Myocardial infarction (MI) is a severe disease with high mortality worldwide. However, regenerative approaches remain limited and with poor efficacy. The major difficulty during MI is the substantial loss of cardiomyocytes (CMs) with limited capacity to regenerate. As a result, for decades, researchers have been engaged in developing useful therapies for myocardial regeneration. Gene therapy is an emerging approach for promoting myocardial regeneration. Modified mRNA (modRNA) is a highly potential delivery vector for gene transfer with its properties of efficiency, non-immunogenicity, transiency, and relative safety. Here, we discuss the optimization of modRNA-based therapy, including gene modification and delivery vectors of modRNA. Moreover, the effective of modRNA in animal MI treatment is also discussed. We conclude that modRNA-based therapy with appropriate therapeutical genes can potentially treat MI by directly promoting proliferation and differentiation, inhibiting apoptosis of CMs, as well as enhancing paracrine effects in terms of promoting angiogenesis and inhibiting fibrosis in heart milieu. Finally, we summarize the current challenges of modRNA-based cardiac treatment and look forward to the future direction of such treatment for MI. Further advanced clinical trials incorporating more MI patients should be conducted in order for modRNA therapy to become practical and feasible in real-world treatment.

Automated summary

Myocardial infarction (MI) is a severe and highly fatal disease. Regenerative approaches for MI have been limited and ineffective due to the loss of cardiomyocytes (CMs) with limited regenerative capacity. Gene therapy using modified mRNA (modRNA) as a delivery vector is a promising approach for promoting myocardial regeneration. This article discusses the optimization of modRNA-based therapy and its effectiveness in treating animal models of MI. The potential benefits of modRNA therapy include promoting CM proliferation and differentiation, inhibiting apoptosis of CMs, and enhancing paracrine effects to promote angiogenesis and inhibit fibrosis in the heart. However, further clinical trials are needed to make modRNA therapy practical and feasible for real-world MI treatment.