Frontiers in precision medicine: genes and their modulation by miRNAs.

Abstract

![Graphic][1] Precision medicine is the vision of utilizing genetic information to discover individual disease mechanisms, better characterize patients at risk, and focus treatments and interventions on those truly in need.1 One might argue that we already do so by obtaining family history and lifestyle habits including smoking, and by measuring blood pressure, LDL-cholesterol, and plasma glucose as recommended by practice guidelines.2–4 However, it is obvious that some smokers never get a tumour or an infarct, even some with familial hypercholesterolaemia are protected from atherosclerosis, and certain diabetics never get renal failure— the so-called Helmut Schmidt or Winston Churchill syndrome. Precision medicine, among others, attempts to characterize the genetic background that determines the susceptibility or resistance to cardiovascular risk factors and eventually the propensity to develop major cardiovascular events.5 We recently learned that gene transcription and translation is modulated by a vast number of so-called microRNAs (miRNAs).6 MiRNAs have been measured in plasma in many conditions, but may be more important in critical tissues regulating metabolism, circulatory control,7 inflammatory heart disease,8 and eventually for clinical outcome.9 The liver is crucial for metabolic regulation and thus the review entitled ‘ Liver microRNAs : potential mediators and biomarkers for metabolic and cardiovascular disease? ’, authored by Manuel Mayr and colleagues from the King’s College London in the UK is a timely update on the subject.10 The authors summarize the rapidly evolving knowledge about liver miRNAs, such as miR-33, -33*, -22, -30c, -144, -148a, -24, -29, and -122, and their role in hepatic lipid metabolism, metabolic syndrome, and type-2 diabetes, and in turn atherosclerosis and cardiovascular disease as well as in non-alcoholic fatty liver disease. miR-122 has the greatest potential as a biomarker as it represents the most abundant and most specific liver miRNA. miR-122 plays a … [1]: /embed/inline-graphic-1.gif