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.
Keywords: AAV, adeno-associated virus; CHIP, clonal hematopoiesis of indeterminate potential; CVD, cardiovascular diseases; LTL, leukocyte telomere length; TCA, telomere-CHIP-atherosclerosis; TERC, telomerase RNA component; TERT, telomerase reverse transcriptase; TRF2, telomere repeat-binding factor 2; aging; atherosclerosis; cardiomyocytes; immune modulation; telomeres.
© 2019 The Authors.