The Yin-Yang Dynamics in Cardiovascular Pharmacogenomics and Personalized Medicine.

Abstract

Studies of genetic variants and systems biology have indicated that Yin-Yang dynamics are especially meaningful for cardiovascular pharmacogenomics and personalized therapeutic strategies. The comprehensive concepts of Yin-Yang can be used to characterize the dynamical factors in the adaptive microenvironments of the complex cardiovascular systems. The Yin-Yang imbalances in the complex adaptive systems (CAS) at different levels and stages are essential for cardiovascular diseases (CVDs), including atherosclerosis, hypertension, and heart failure (HF). At the molecular and cellular levels, Yin-Yang interconnections have been considered critical for genetic variants and various pathways, mitophagy, cell death, and cholesterol homeostasis. The significance of the adaptive and spatiotemporal factors in the nonlinear Yin-Yang interactions has been identified in different pathophysiological processes such as fibrosis. The Yin-Yang dynamical balances between proinflammatory and anti-inflammatory cytokines have vital roles in the complex reactions to stress and impairments to the heart. Procoagulant and anticoagulant lipids and lipoproteins in plasma have the Yin-Yang roles that increase or decrease thrombin productions and thrombosis. At the systems level, the Yin-Yang type of relationships has been suggested between atrial fibrillation (AF), diastolic dysfunction (DD), and HF. Based on such perceptions, systemic and personalized cardiovascular profiles can be constructed by embracing the features of CAS, especially the microenvironments and the adaptative pathophysiological stages. These features can be integrated into the comprehensive Yin-Yang dynamics framework to identify more accurate biomarkers for better prevention and treatments. The goal of reestablishing ubiquitous Yin-Yang dynamical balances may become the central theme for personalized and systems medicine for cardiovascular diseases.