Unfolded protein response as a therapeutic target in cardiovascular disease

Guangyu Zhang, Xiaoding Wang, Thomas G. Gillette, Yingfeng Deng, Zhao V. Wang

Research output: Contribution to journalReview articlepeer-review

25 Scopus citations


Cardiovascular disease is the leading cause of death worldwide. Despite overwhelming socioeconomic impact and mounting clinical needs, our understanding of the underlying pathophysiology remains incomplete. Multiple forms of cardiovascular disease involve an acute or chronic disturbance in cardiac myocytes, which may lead to potent activation of the Unfolded Protein Response (UPR), a cellular adaptive reaction to accommodate protein-folding stress. Accumulation of unfolded or mis-folded proteins in the Endoplasmic Reticulum (ER) elicits three signaling branches of the UPR, which otherwise remain quiescent. This ER stress response then transiently suppresses global protein translation, augments production of protein-folding chaperones, and enhances ER-associated protein degradation, with an aim to restore cellular homeostasis. Ample evidence has established that the UPR is strongly induced in heart disease. Recently, the mechanisms of action and multiple pharmacological means to favorably modulate the UPR are emerging to curb the initiation and progression of cardiovascular disease. Here, we review the current understanding of the UPR in cardiovascular disease and discuss existing therapeutic explorations and future directions.

Original languageEnglish (US)
Pages (from-to)1902-1917
Number of pages16
JournalCurrent topics in medicinal chemistry
Issue number21
StatePublished - 2019


  • ATF6
  • Cardiovascular disease
  • Endoplasmic reticulum
  • GRP78
  • IRE1
  • Ischemic heart disease
  • PERK
  • Pathological cardiac remodeling
  • Unfolded protein response
  • XBP1s

ASJC Scopus subject areas

  • Drug Discovery


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