4. Conclusion
In order to solve the above problems, we may find clues from the following aspects: (i) Excavating high-specific autophagy biomarkers and optimal cardiac hypertrophy animal models: Under ideal conditions, high-specific autophagy biomarkers may be autophagy-related genes and proteins in blood and urine, which can accurately reflect the exact autophagic activity of the myocardia at different stages [77]. Then, reflecting disease progression through changes in autophagic biomarkers can not only reduce the damage to the patient’s body and the economic burden, but also effectively reflect the disease process and provide an important reference for the treatment of cardiac hypertrophy. (ii) Ensuring the specificity of autophagy modulators: We can monitor the process of disease through the changes of autophagy biomarkers, and then use autophagy inhibitors/inducers to treat diseases accordingly. Due to the complex metabolic process of drugs in vivo, the mechanism of the drug efficacy must be clear to effectively avoid the side effects of the drugs, so as to improve the safety and effectiveness of the drugs. Therefore, the specificity of autophagy modulators is crucial. (iii) Real-time monitoring: since autophagy is a double-edged sword, real-time monitoring of autophagy status and drug blood concentration in patients taking autophagy modulators is needed to avoid excessive or insufficient regulation which may aggravate the disease [78].
Overall, existing studies have shown that the role of autophagy on cardiac hypertrophy requires specific analysis and autophagy may be a potential therapeutic target for pathological cardiac hypertrophy. However, the current therapeutic mechanism related to autophagy remains to be further studied. Research and development of autophagy modulators represented by miRNAs may be important potential strategies for treating pathological cardiac hypertrophy. Additionally, since the existing autophagy modulators often have low specificity, improving the specific therapeutic efficacy of autophagy modulators may be a very important research hotspot in the future.