Microtubule dynamics and post-translational modifications in cardiovascular diseases: mechanisms and therapeutic implications

Microtubules, assembled from tubulin subunits, as a core component of the cytoskeleton, are extensively involved in fundamental biological activities such as cell shape maintenance, material transport, and cell division. Recent studies have revealed that abnormal microtubules dynamics and post-translational modifications (PTMs) of tubulin in cardiovascular diseases profoundly impact the function of cardiomyocytes and vascular smooth muscle cells, positioning the microtubule cytoskeleton as a key factor in cardiovascular pathophysiological processes. Specifically, alterations in microtubule stability and tubulin modifications influence cellular damage repair following myocardial ischemia but also regulate the development mechanisms of heart failure and atherosclerosis, demonstrating their multifaceted role in disease development. This systematic review examines microtubule dynamics and tubulin PTMs across various cardiovascular diseases and their underlying molecular mechanisms, with a focus on their potential as a therapeutic target. It aims to provide novel theoretical support and innovative insights for the diagnosis and treatment of cardiovascular diseases, thereby advancing clinical translation in this field.