miRNAs in atherosclerotic plaque initiation, progression, and rupture

• miRNAs regulate diverse cell types involved in atherosclerotic disease progression.
• miRNAs are implicated in advanced atherosclerotic plaque rupture.
• Circulating miRNAs are promising new candidates as biomarkers for atherosclerosis.
• Pharmacological targeting of dysregulated miRNAs is a promising therapeutic concept.

Atherosclerosis is a chronic immune-inflammatory disorder that integrates multiple cell types and a diverse set of inflammatory mediators. miRNAs are emerging as important post-transcriptional regulators of gene expression in most, if not all, vertebrate cells, and constitute central players in many physiological and pathological processes. Rapidly accumulating experimental studies reveal their key role in cellular and molecular processes related to the development of atherosclerosis. We review current evidence for the involvement of miRNAs in early atherosclerotic lesion formation and in plaque rupture and erosion. We conclude with a perspective on the clinical relevance, therapeutic opportunities, and future challenges of miRNA biology in understanding the pathogenesis of this complex disease.