Eur J Pharmacol. 2025 Nov 06. pii: S0014-2999(25)01098-2. [Epub ahead of print] 178344
Cardiovascular diseases (CVDs) remain the leading cause of global mortality, highlighting the urgent need for innovative therapeutic strategies. Methyltransferase-like proteins (METTLs), which harbor conserved S-adenosylmethionine (SAM)-binding and catalytic domains, dynamically regulate the functions of RNA, DNA, and proteins through diverse methylation modifications (e.g., N6-methyladenosine [m6A], N7-methylguanosine [m7G], 3-methylcytidine/4-methylcytidine [m3C/m4C], N6-methyladenine [6mA]). These modifications play pivotal roles in fundamental cellular processes such as proliferation, apoptosis, inflammation, and metabolism, and their dysregulation is directly implicated in CVD pathogenesis. This review compiles compelling evidence that connects aberrant METTL expression and activity to major CVDs such as myocardial infarction, maladaptive cardiac remodeling, atherosclerosis, and arrhythmias. We detail how METTLs influence myocardial injury/repair, fibrosis, vascular dysfunction, and electrophysiological homeostasis by altering RNA stability, translation efficiency, and signaling cascades. Additionally, we critically assess the emerging translational potential of METTL members as diagnostic/prognostic biomarkers and inhibitor development strategies. By clarifying the complex mechanisms of METTL-mediated epitranscriptomic and epigenetic regulation, this work lays the groundwork for advancing precision medicine approaches in CVD prevention and treatment.
Keywords: METTL family; biomarker; cardiovascular diseases; methylation modifications; therapeutic target