CardioSomaticsCardioSomaticsCardioСоматика2221-71852658-5707Eco-Vector63222610.17816/CS632226ReviewsОбзорыReview ArticleProspects of using miRNA-378 as a biomarker for cardiovascular diseases: A literature reviewПерспективы использования miRNA-378 в качестве сердечно-сосудистого биологического маркера: обзор литературыhttps://orcid.org/0000-0001-5416-85792749-6427AlievaAmina M.АлиеваАмина Магомедовна
Russian Federation

MD, Cand. Sci. (Medicine), assistant professor

канд. мед. наук, доцент

amisha_alieva@mail.ruhttps://orcid.org/0000-0002-5520-281X2520-8520KhadzhievaNyurzhanna Kh.ХаджиеваНюржанна Хусейновна
Russian Federation

MD, Cand. Sci. (Medicine)

канд. мед. наук

nurzhanna@yandex.ruhttps://orcid.org/0000-0003-0886-62903054-8884BaykovaIrina E.БайковаИрина Евгеньевна
Russian Federation

MD, Cand. Sci. (Medicine), assistant professor

канд. мед. наук, доцент

1498553@mail.ruhttps://orcid.org/0000-0001-9601-11745166-8100RakhaevAlik M.РахаевАлик Магомедович
Russian Federation

MD, Dr. Sci. (Medicine), professor

доктор мед. наук, профессор

alikrahaev@yandex.ruhttps://orcid.org/0000-0001-5352-84991423-7300KotikovaIrina A.КотиковаИрина Александровна
Russian Federation

MD, resident

ординатор

kotikova.ia@mail.ruhttps://orcid.org/0000-0003-1699-08813595-1990NikitinIgor G.НикитинИгорь Геннадиевич
Russian Federation

MD, Dr. Sci. (Medicine), professor

доктор мед. наук, профессор

igor.nikitin.64@mail.ruPirogov Russian National Research Medical UniversityРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаClinic of DNA Genetics “MedEstet”Клиника генетики ДНК «МедЭстет»Kabardino-Balkarian State University named after H.M. BerbekovКабардино-Балкарский государственный университет им. Х.М. Бербекова30082024151120241532212301905202414082024Copyright ©; 2024, Eco-VectorCopyright ©; 2024, ООО "Эко-Вектор"2024Eco-VectorООО "Эко-Вектор"https://creativecommons.org/licenses/by-nc-nd/4.0https://cardiosomatics.ru/2221-7185/article/view/632226

Currently, there is an active search for new biomarkers and therapeutic targets to develop effective approaches to risk stratification and secondary prevention of cardiovascular diseases (CVD). Microribonucleic acids (miRNAs) are of particular interest to investigators. MiRNAs are endogenous small noncoding RNAs that regulate the transcription of factors that play a role in the proliferation, differentiation, cell growth, and tissue remodeling processes in CVD. MiRNA-378 is currently being analyzed as a biomarker for CVD. Thus, in this review, we aimed to describe the regulatory role of miRNA-378 and provide strong evidence for its feasibility as a biomarker. Further preclinical and clinical studies are required to identify the potential benefits of miRNA-378 as a biomarker in CVD.

В настоящее время ведётся активный поиск новых биологических маркеров и терапевтических мишеней с целью разработки эффективных подходов к стратификации риска и вторичной профилактике сердечно-сосудистых заболеваний (ССЗ). Особый интерес исследователей привлекают микрорибонуклеиновые кислоты (miRNAs). MiRNAs относятся к классу эндогенных малых некодирующих RNA. MiRNAs регулируют транскрипцию важных участников процессов пролиферации, дифференцировки, клеточного роста и тканевого ремоделирования при ССЗ. В настоящее время miRNA-378 анализируется в роли биологического маркера ССЗ. В представленной статье описана регуляторная роль miRNA-378 и приведены весомые доказательства целесообразности использования её в качестве биомаркера. Требуются дальнейшие доклинические и клинические исследования для выявления потенциальных преимуществ использования miRNA-378 в качестве биологического маркера при ССЗ.

cardiovascular diseasesbiomarkersmicro ribonucleic acid-378сердечно-сосудистые заболеваниябиологические маркерымикрорибонуклеиновая кислота-378Alieva AM, Teplova NV, Kislyakov VA, et al. Biomarkers in cardiology: microrna and heart failure. Terapija. 2022;(1):60–70. doi: 10.18565/therapy.2022.1.60-70Алиева А.М., Теплова Н.В., Кисляков В.А., и др. Биомаркеры в кардиологии: микроРНК и сердечная недостаточность // Терапия. 2022. № 1. С. 60–70. doi: 10.18565/therapy.2022.1.60-70Li X, Han Y, Meng Y, et al. Small RNA-big impact: exosomal miRNAs in mitochondrial dysfunction in various diseases. RNA Biol. 2024;21(1):1–20. doi: 10.1080/15476286.2023.2293343Li X., Han Y., Meng Y., et al. Small RNA-big impact: exosomal miRNAs in mitochondrial dysfunction in various diseases // RNA Biol. 2024. Vol. 1, N. 1. P. 1–20. doi: 10.1080/15476286.2023.2293343Searles CD. MicroRNAs and Cardiovascular Disease Risk. Curr Cardiol Rep. 2024;26(2):51–60. doi: 10.1007/s11886-023-02014-1Searles C.D. MicroRNAs and Cardiovascular Disease Risk // Curr Cardiol Rep. 2024. Vol. 26, № 2. P. 51–60. doi: 10.1007/s11886-023-02014-1Yan J, Zhong X, Zhao Y, et al. Role and mechanism of miRNA in cardiac microvascular endothelial cells in cardiovascular diseases. Front Cardiovasc Med. 2024;11:1356152. doi: 10.3389/fcvm.2024.1356152Yan J., Zhong X., Zhao Y., et al. Role and mechanism of miRNA in cardiac microvascular endothelial cells in cardiovascular diseases // Front Cardiovasc Med. 2024. Vol. 11. P. 1356152. doi: 10.3389/fcvm.2024.1356152Cao Y, Zheng M, Sewani MA, et al. The miR-17-92 cluster in cardiac health and disease. Birth Defects Res. 2024;116(1):e2273. doi: 10.1002/bdr2.2273Cao Y., Zheng M., Sewani M.A., et al. The miR-17-92 cluster in cardiac health and disease. Birth Defects Res // Birth Defects Res. 2024. Vol. 116, N. 1. P. e2273. doi: 10.1002/bdr2.2273Alieva AM, Reznik EV, Teplova NV, et al. MicroRNA-34a in cardiovascular disease: a glimpse into the future. Russian Cardiology Bulletin. 2023;18(1):14–22. doi: 10.17116/Cardiobulletin20231801114Алиева А.М., Резник Е.В., Теплова Н.В., и др. МикроРНК-34а при сердечно-сосудистых заболеваниях: взгляд в будущее // Кардиологический вестник. 2023. Т. 18, № 1. С. 14–22. doi: 10.17116/Cardiobulletin20231801114Wang H, Shi J, Wang J, et al. MicroRNA-378: An important player in cardiovascular diseases (Review). Mol Med Rep. 2023;28(3):172. doi: 10.3892/mmr.2023.13059Wang H., Shi J., Wang J., et al. MicroRNA-378: An important player in cardiovascular diseases (Review) // Mol Med Rep. 2023. Vol. 28, N. 3. P. 172. doi: 10.3892/mmr.2023.13059Alieva AM, Teplova NV, Reznik EV, et al. miRNA-122 as a new player in cardiovascular disease. Rossiiskii meditsinskii zhurnal. 2022;28(4):451–463. doi: 10.17816/medjrf111180Алиева А.М., Теплова Н.В., Резник Е.В., и др. МикроРНК-122 как новый игрок при сердечно-сосудистых заболеваниях // Российский медицинский журнал. 2022. Т. 28, № 6. С. 451–463. doi: 10.17816/medjrf111180Krist B, Florczyk U, Pietraszek-Gremplewicz K, et al. The Role of miR-378a in Metabolism, Angiogenesis, and Muscle Biology. Int J Endocrinol. 2015;2015:281756. doi: 10.1155/2015/281756Krist B., Florczyk U., Pietraszek-Gremplewicz K., et al. The Role of miR-378a in Metabolism, Angiogenesis, and Muscle Biology // Int J Endocrinol. 2015. Vol. 2015. P. 281756. doi: 10.1155/2015/281756Kuang Z, Wu J, Tan Y, et al. MicroRNA in the Diagnosis and Treatment of Doxorubicin-Induced Cardiotoxicity. Biomolecules. 2023;13(3):568. doi: 10.3390/biom13030568Kuang Z., Wu J., Tan Y., et al. MicroRNA in the diagnosis and treatment of doxorubicin-induced cardiotoxicity // Biomolecules. 2023. Vol. 13, N. 3. P. 568. doi: 10.3390/biom13030568Li Y, Jiang J, Liu W, et al. microRNA-378 promotes autophagy and inhibits apoptosis in skeletal muscle. Proc Natl Acad Sci U S A. 2018;115(46):E10849–E10858. doi: 10.1073/pnas.1803377115Li Y., Jiang J., Liu W., et al. microRNA-378 promotes autophagy and inhibits apoptosis in skeletal muscle // Proc Natl Acad Sci U S A. 2018. Vol. 115, N. 46. P. E10849–E10858. doi: 10.1073/pnas.1803377115Camps C, Saini HK, Mole DR, et al. Integrated analysis of microRNA and mRNA expression and association with HIF binding reveals the complexity of microRNA expression regulation under hypoxia. Mol Cancer. 2014;13:28. doi: 10.1186/1476-4598-13-28Camps C., Saini H.K., Mole D.R., et al. Integrated analysis of microRNA and mRNA expression and association with HIF binding reveals the complexity of microRNA expression regulation under hypoxia // Mol Cancer. 2014. Vol. 13. P. 28. doi: 10.1186/1476-4598-13-28Zhang J, Ma J, Long K, et al. Overexpression of exosomal cardioprotective miRNAs mitigates hypoxia-induced H9c2 cells apoptosis. Int J Mol Sci. 2017;18(4):711. doi: 10.3390/ijms18040711Zhang J., Ma J., Long K., et al. Overexpression of exosomal cardioprotective miRNAs mitigates hypoxia-induced H9c2 cells apoptosis // Int J Mol Sci. 2017. Vol. 18, N. 4. P. 711. doi: 10.3390/ijms18040711Xing Y, Hou J, Guo T, et al. microRNA-378 promotes mesenchymal stem cell survival and vascularization under hypoxic-ischemic conditions in vitro. Stem Cell Res Ther. 2014;5(6):130. doi: 10.1186/scrt520Xing Y., Hou J., Guo T., et al. microRNA-378 promotes mesenchymal stem cell survival and vascularization under hypoxic-ischemic conditions in vitro // Stem Cell Res Ther. 2014. Vol. 5, N. 6. P. 130. doi: 10.1186/scrt520Zhang H, Hao J, Sun X, et al. Circulating pro-angiogenic micro-ribonucleic acid in patients with coronary heart disease. Interact Cardiovasc Thorac Surg. 2018;27(3):336–342. doi: 10.1093/icvts/ivy058Zhang H., Hao J., Sun X., et al. Circulating pro-angiogenic micro-ribonucleic acid in patients with coronary heart disease // Interact Cardiovasc Thorac Surg. 2018. Vol. 27, N. 3. P. 336–342. doi: 10.1093/icvts/ivy058Templin C, Volkmann J, Emmert MY, et al. Increased proangiogenic activity of mobilized CD34+ progenitor cells of patients with acute ST-segment-elevation myocardial infarction: Role of differential microRNA-378 expression. Arterioscler Thromb Vasc Biol. 2017;37(2):341–349. doi: 10.1161/ATVBAHA.116.308695Templin C., Volkmann J., Emmert M.Y., et al. Increased proangiogenic activity of mobilized CD34+ progenitor cells of patients with acute ST-segment-elevation myocardial infarction: Role of differential microRNA-378 expression // Arterioscler Thromb Vasc Biol. 2017. Vol. 37, N. 2. P. 341–349. doi: 10.1161/ATVBAHA.116.308695Chong H, Wei Z, Na M, et al. The PGC-1α/NRF1/miR-378a axis protects vascular smooth muscle cells from FFA-induced proliferation, migration and inflammation in atherosclerosis. Atherosclerosis. 2020;297:136–145. doi: 10.1016/j.atherosclerosis.2020.02.001Chong H., Wei Z., Na M., et al. The PGC-1α/NRF1/miR-378a axis protects vascular smooth muscle cells from FFA-induced proliferation, migration and inflammation in atherosclerosis // Atherosclerosis. 2020. Vol. 297. P. 136–145. doi: 10.1016/j.atherosclerosis.2020.02.001Chen W, Li X, Wang J, et al. miR-378a modulates macrophage phagocytosis and differentiation through targeting CD47-SIRPα axis in atherosclerosis. Scand J Immunol. 2019;90(1):e12766. doi: 10.1111/sji.12766Chen W., Li X., Wang J., et al. miR-378a modulates macrophage phagocytosis and differentiation through targeting CD47-SIRPα axis in atherosclerosis // Scand J Immunol. 2019. Vol. 90, N. 1. P. e12766. doi: 10.1111/sji.12766Yuan W, Liang X, Liu Y, et al. Mechanism of miR-378a-3p enriched in M2 macrophage-derived extracellular vesicles in cardiomyocyte pyroptosis after MI. Hypertens Res. 2022;45(4):650–664. doi: 10.1038/s41440-022-00851-1Yuan W., Liang X., Liu Y., et al. Mechanism of miR-378a-3p enriched in M2 macrophage-derived extracellular vesicles in cardiomyocyte pyroptosis after MI // Hypertens Res. 2022. Vol. 45, N. 4. P. 650–664. doi: 10.1038/s41440-022-00851-1Zhou R, Jia Y, Wang Y, et al. Elevating miR-378 strengthens the isoflurane-mediated effects on myocardial ischemia-reperfusion injury in mice via suppression of MAPK1. Am J Transl Res. 2021;13(4):2350–2364.Zhou R., Jia Y., Wang Y., et al. Elevating miR-378 strengthens the isoflurane-mediated effects on myocardial ischemia-reperfusion injury in mice via suppression of MAPK1 // Am J Transl Res. 2021. Vol. 13, N. 4. P. 2350–2364.Yan T, Li X, Nian T, et al. Salidroside inhibits ischemia/reperfusion-induced myocardial apoptosis by targeting mir-378a-3p via the IGF1R/PI3K/AKT signaling pathway. Transplant Proc. 2022;54(7):1970–1983. doi: 10.1016/j.transproceed.2022.05.017Yan T., Li X., Nian T., et al. Salidroside inhibits ischemia/reperfusion-induced myocardial apoptosis by targeting mir-378a-3p via the IGF1R/PI3K/AKT signaling pathway // Transplant Proc. 2022. Vol. 54, N. 7. P. 1970–1983. doi: 10.1016/j.transproceed.2022.05.017Ganesan J, Ramanujam D, Sassi Y, et al. MiR-378 controls cardiac hypertrophy by combined repression of mitogen-activated protein kinase pathway factors. Circulation. 2013;127(21):2097–2106. doi: 10.1161/CIRCULATIONAHA.112.000882Ganesan J., Ramanujam D., Sassi Y., et al. MiR-378 controls cardiac hypertrophy by combined repression of mitogen-activated protein kinase pathway factors // Circulation. 2013. Vol. 127, N. 21. P. 2097–2106. doi: 10.1161/CIRCULATIONAHA.112.000882Chen YH, Zhong LF, Hong X, et al. Integrated Analysis of circRNA-miRNA-mRNA ceRNA Network in Cardiac Hypertrophy. Front Genet. 2022;13:781676. doi: 10.3389/fgene.2022.781676Chen Y.H., Zhong L.F., Hong X., et al. Integrated analysis of circRNA-miRNA-mRNA ceRNA network in cardiac hypertrophy // Front Genet. 2022. Vol. 13. P. 781676. doi: 10.3389/fgene.2022.781676Sun F, Zhuang Y, Zhu H, et al. LncRNA PCFL promotes cardiac fibrosis via miR-378/GRB2 pathway following myocardial infarction. J Mol Cell Cardiol. 2019;133:188–198. doi: 10.1016/j.yjmcc.2019.06.011Sun F., Zhuang Y., Zhu H., et al. LncRNA PCFL promotes cardiac fibrosis via miR-378/GRB2 pathway following myocardial infarction // J Mol Cell Cardiol. 2019. Vol. 133. P. 188–198. doi: 10.1016/j.yjmcc.2019.06.011Wu L, Gao B, Shen M, et al. lncRNA LENGA sponges miR-378 to promote myocardial fibrosis in atrial fibrillation. Open Med (Wars). 2023;18(1):20230831. doi: 10.1515/med-2023-0831Wu L., Gao B., Shen M., et al. lncRNA LENGA sponges miR-378 to promote myocardial fibrosis in atrial fibrillation // Open Med (Wars). 2023. Vol. 18, N. 1. P. 20230831. doi: 10.1515/med-2023-0831Florczyk-Soluch U, Polak K, Sabo R, et al. Compromised diabetic heart function is not affected by miR-378a upregulation upon hyperglycemia. Pharmacol Rep. 2023;75(6):1556–1570. doi: 10.1007/s43440-023-00535-8Florczyk-Soluch U., Polak K., Sabo R., et al. Compromised diabetic heart function is not affected by miR-378a upregulation upon hyperglycemia // Pharmacol Rep. 2023. Vol. 75, N. 6. P. 1556–1570. doi: 10.1007/s43440-023-00535-8Li X. lncRNA MALAT1 promotes diabetic retinopathy by upregulating PDE6G via miR-378a-3p. Arch Physiol Biochem. 2021;21:1–9. doi: 10.1080/13813455.2021.1985144Li X. lncRNA MALAT1 promotes diabetic retinopathy by upregulating PDE6G via miR-378a-3p // Arch Physiol Biochem. 2021. Vol. 21. P. 1–9. doi: 10.1080/13813455.2021.1985144Froldi G. View on metformin: Antidiabetic and pleiotropic effects, pharmacokinetics, side effects, and sex-related differences. Pharmaceuticals (Basel). 2024;17(4):478. doi: 10.3390/ph17040478Froldi G. View on Metformin: Antidiabetic and Pleiotropic Effects, Pharmacokinetics, Side Effects, and Sex-Related Differences // Pharmaceuticals (Basel). 2024. Vol. 17, N. 4. P. 478. doi: 10.3390/ph17040478Khokhar M, Roy D, Bajpai NK, et al. Metformin mediates microRNA-21 regulated circulating matrix metalloproteinase-9 in diabetic nephropathy: an in-silico and clinical study. Arch Physiol Biochem. 2023;129(6):1200–1210. doi: 10.1080/13813455.2021.1922457Khokhar M., Roy D., Bajpai N.K., et al. Metformin mediates MicroRNA-21 regulated circulating matrix metalloproteinase-9 in diabetic nephropathy: an in-silico and clinical study // Arch Physiol Biochem. 2023. Vol. 129, N. 6. P. 1200–1210. doi: 10.1080/13813455.2021.1922457Machado IF, Teodoro JS, Castela AC, et al. miR-378a-3p participates in metformin's mechanism of action on C2C12 cells under hyperglycemia. Int J Mol Sci. 2021;22(2):541. doi: 10.3390/ijms22020541Machado I.F., Teodoro J.S., Castela A.C., et al. miR-378a-3p participates in metformin's mechanism of action on C2C12 cells under hyperglycemia // Int J Mol Sci. 2021. Vol. 22, N. 2. P. 541. doi: 10.3390/ijms22020541Chaulin AM. The essential strategies to mitigate cardiotoxicity caused by Doxorubicin. Life (Basel). 2023;13(11):2148. doi: 10.3390/life13112148Chaulin A.M. The essential strategies to mitigate cardiotoxicity caused by doxorubicin // Life (Basel). 2023. Vol. 13, N. 11. P. 2148. doi: 10.3390/life13112148Mattioli R, Ilari A, Colotti B, et al. Doxorubicin and other anthracyclines in cancers: Activity, chemoresistance and its overcoming. Mol Aspects Med. 2023;93:101205. doi: 10.1016/j.mam.2023.101205Mattioli R., Ilari A., Colotti B., et al. Doxorubicin and other anthracyclines in cancers: Activity, chemoresistance and its overcoming // Mol Aspects Med. 2023. Vol. 93. P. 101205. doi: 10.1016/j.mam.2023.101205Wang Y, Zhang Q, Wei C, et al. MiR-378 modulates energy imbalance and apoptosis of mitochondria induced by doxorubicin. Am J Transl Res. 2018;10(11):3600–3609.Wang Y., Zhang Q., Wei C., et al. MiR-378 modulates energy imbalance and apoptosis of mitochondria induced by doxorubicin // Am J Transl Res. 2018. Vol. 10, N. 11. P. 3600–3609.Wang Y, Cui X, Wang Y, et al. Protective effect of miR378* on doxorubicin-induced cardiomyocyte injury via calumenin. J Cell Physiol. 2018;233(10):6344–6351. doi: 10.1002/jcp.26615Wang Y., Cui X., Wang Y., et al. Protective effect of miR378* on doxorubicin-induced cardiomyocyte injury via calumenin // J Cell Physiol. 2018. Vol. 233, N. 10. P. 6344–6351. doi: 10.1002/jcp.26615Zhang H, Hao J, Sun X, et al. Circulating pro-angiogenic micro-ribonucleic acid in patients with coronary heart disease. Interact Cardiovasc Thorac Surg. 2018;27(3):336–342. doi: 10.1093/icvts/ivy058Zhang H., Hao J., Sun X., et al. Circulating pro-angiogenic micro-ribonucleic acid in patients with coronary heart disease // Interact Cardiovasc Thorac Surg. 2018. Vol. 27, N. 3. P. 336–342. doi: 10.1093/icvts/ivy058Li H, Gao F, Wang X, et al. Circulating microRNA-378 levels serve as a novel biomarker for assessing the severity of coronary stenosis in patients with coronary artery disease. Biosci Rep. 2019;39(5):BSR20182016. doi: 10.1042/BSR20182016Li H., Gao F., Wang X., et al. Circulating microRNA-378 levels serve as a novel biomarker for assessing the severity of coronary stenosis in patients with coronary artery disease // Biosci Rep. 2019. Vol. 39, N. 5. P. BSR20182016. doi: 10.1042/BSR20182016Shen J, Chang C, Ma J, et al. Potential of circulating proangiogenic microRNAs for predicting major adverse cardiac and cerebrovascular events in unprotected left main coronary artery disease patients who underwent coronary artery bypass grafting. Cardiology. 2021;146(3):400–408. doi: 10.1159/000509275Shen J., Chang C., Ma J., et al. Potential of circulating proangiogenic microRNAs for predicting major adverse cardiac and cerebrovascular events in unprotected left main coronary artery disease patients who underwent coronary artery bypass grafting // Cardiology. 2021. Vol. 146, N. 3. P. 400–408. doi: 10.1159/000509275Dai R, Liu Y, Zhou Y, et al. Potential of circulating pro-angiogenic microRNA expressions as biomarkers for rapid angiographic stenotic progression and restenosis risks in coronary artery disease patients underwent percutaneous coronary intervention. J Clin Lab Anal. 2020;34(1):e23013. doi: 10.1002/jcla.23013Dai R., Liu Y., Zhou Y., et al. Potential of circulating pro-angiogenic microRNA expressions as biomarkers for rapid angiographic stenotic progression and restenosis risks in coronary artery disease patients underwent percutaneous coronary intervention // J Clin Lab Anal. 2020. Vol. 34, N. 1. P. e23013. doi: 10.1002/jcla.23013Chen Z, Li C, Xu Y, et al. Circulating level of miR-378 predicts left ventricular hypertrophy in patients with aortic stenosis. PLoS One. 2014;9(8):e105702. doi: 10.1371/journal.pone.0105702Chen Z., Li C., Xu Y., et al. Circulating level of miR-378 predicts left ventricular hypertrophy in patients with aortic stenosis // PLoS One. 2014. Vol. 9, N. 8. P. e105702. doi: 10.1371/journal.pone.0105702Begrambekova YuL, Karanadze NA, Plisyuk AG, et al. Comprehensive physical rehabilitation of patients with heart failure: impact on clinical and functional status and analysis of problems related to the enrollment. Russian Journal of Cardiology. 2022;27(2):4814. doi: 10.15829/1560-4071-2022-4814Беграмбекова Ю.Л., Каранадзе Н.А., Плисюк А.Г., и др. Комплексная физическая реабилитация пациентов с хронической сердечной недостаточностью: влияние на клиникофункциональные показатели и анализ проблем, связанных с набором в исследование // Российский кардиологический журнал. 2022. Т. 27, № 2. С. 4814. doi: 10.15829/1560-4071-2022-4814Pala M. Exercise and microrna. Georgian Med News. 2023;(345):146–153.Pala M. Exercise and microrna // Georgian Med News. 2023. N. 345. P. 146–153.Xu T, Zhou Q, Che L, et al. Circulating miR-21, miR-378, and miR-940 increase in response to an acute exhaustive exercise in chronic heart failure patients. Oncotarget. 2016;7(11):12414–12425. doi: 10.18632/oncotarget.6966Xu T., Zhou Q., Che L., et al. Circulating miR-21, miR-378, and miR-940 increase in response to an acute exhaustive exercise in chronic heart failure patients // Oncotarget. 2016. Vol. 7, N. 11. P. 12414–12425. doi: 10.18632/oncotarget.6966