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Emerging roles of the cGAS/STING pathway in cardiovascular diseases
Wataru Saitoh, Yasutomi Higashikuni, Oyunbileg Bavuu, Masataka Sata, Daiju Fukuda
Wataru Saitoh, Yasutomi Higashikuni, Oyunbileg Bavuu, Masataka Sata, Daiju Fukuda
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Review Series

Emerging roles of the cGAS/STING pathway in cardiovascular diseases

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Abstract

Cardiovascular diseases (CVDs) remain the leading cause of mortality and morbidity worldwide, highlighting the need for novel therapeutic approaches. Inflammation plays a key role in CVD pathogenesis, and accumulating evidence has implicated the cyclic GMP-AMP synthase/stimulator of IFN genes (cGAS/STING) pathway in this process. The cGAS/STING pathway recognizes both non-self- and self-DNA, including mitochondrial and nuclear DNA, to activate its downstream proinflammatory signaling molecules, including TANK-binding kinase 1, IFN regulatory factor 3, and NF-κB. Various pathological stressors have been shown to induce self-DNA release into the cytosol and bloodstream from damaged cells in the cardiovascular system, indicating that circulating cell-free DNA is a useful biomarker of CVDs; however, how this contributes to the inflammatory signaling, cell death, and fibrosis that characterize CVDs remains unclear. Here, we discuss the current understanding on the roles of self-DNA and the cGAS/STING pathway in the pathophysiology of CVDs and the therapeutic potential of targeting this pathway.

Authors

Wataru Saitoh, Yasutomi Higashikuni, Oyunbileg Bavuu, Masataka Sata, Daiju Fukuda

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Figure 1

The cGAS/STING pathway and cardiovascular diseases.

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The cGAS/STING pathway and cardiovascular diseases.
(A) Risk factors ass...
(A) Risk factors associated with cardiovascular disease — such as aging, sex differences, obesity, and smoking — contribute to the accumulation of intracellular nuclear DNA and mtDNA and extracellular cell-free DNA (cfDNA), which activate both canonical and noncanonical cGAS/STING signaling. (B) Activation of the cGAS/STING pathway modulates the function of vascular and cardiac cells, including vascular smooth muscle cells (VSMCs), vascular endothelial cells (ECs), immune cells, cardiomyocytes, and fibroblasts. This causes functional and structural changes of the blood vessels and heart, contributing to the pathophysiology of cardiovascular diseases, including atherosclerosis, hypertension, pulmonary hypertension, aortic aneurysm and dissection, myocardial infarction, myocardial ischemia/reperfusion injury, hypertensive heart disease, valvular heart disease, cardiomyopathy, myocarditis, and atrial fibrillation.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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