RNA修饰由于其在广泛的细胞网络和信号通路中的广泛调节作用而最近引起了极大的关注。在心血管疾病 (CVD) 中，所有 RNA 分子（tRNA、rRNA、mRNA 和 ncRNA）中都存在多种 RNA 变化，称为“表观转录组”改变。与影响动脉粥样硬化（AS）进展的表观遗传过程不同，其转录和转录后调节机制仍不清楚。在这里，我们描述了主要的表观转录组标志，以提供对 AS 的新见解，包括 m6A、m5C、m1A、m7G、Ψ 和 A-to-I 编辑。此外，我们还包括所有当前已知的 RNA 修饰剂靶向，包括小分子抑制剂或激活剂，主要针对 m6A 和 m5A 相关酶设计，例如 METTL3、FTO 和 ALKBH5。最后，由于只有少数药物（如阿扎胞苷和他泽美司他）已获得 FDA 批准，靶向 DNA 表观基因组，下一个挑战将是识别靶向 RNA 表观转录组的分子。迄今为止，三七总皂苷可以通过Wilms肿瘤相关蛋白1 m6A依赖性减少血管增生。事实上，虚拟筛选使我们能够分离出一种植物分子——大黄酸，它通过增加 mRNA m6A 水平来充当 FTO 抑制剂。在这篇综述中，我们重点介绍了与 AS 相关的 RNA 表观转录组通路，描述了它们的生物学功能及其与疾病的联系。表观转录组敏感通路的鉴定可以为寻找精准医学的预测、诊断和预后生物标志物提供新的机会。版权所有© Bentham Science Publishers；如有任何疑问，请发送电子邮件至 epub@benthamscience.net。

RNA modifications have recently gained great attention due to their extensive regulatory effects in a wide range of cellular networks and signaling pathways. In cardiovascular diseases (CVDs), several RNA changes, called "epitranscriptome" alterations, are found in all RNA molecules (tRNA, rRNA, mRNA, and ncRNAs). Unlike the epigenetic process, which influences the progression of atherosclerosis (AS), its transcriptional and post-transcriptional regulatory mechanisms are still unknown. Here, we described the main epitranscriptome signs to provide new insights into AS, including m6A, m5C, m1A, m7G, Ψ, and A-to-I editing. Moreover, we also included all current known RNA-- modifier-targeting, including small molecular inhibitors or activators, mainly designed against m6A- and m5A-related enzymes, such as METTL3, FTO, and ALKBH5. Finally, since only a few drugs, such as azacitidine and tazemetostat, targeting the DNA epigenome, have been approved by the FDA, the next challenge would be to identify molecules for targeting the RNA epitranscriptome. To date, total Panax notoginseng total saponin could reduce vascular hyperplasia via Wilms' tumor-associated protein-1 m6A-dependent. Indeed, a virtual screening allowed us to individuate a phytomolecule, the rhein, which acts as an FTO inhibitor by increasing mRNA m6A levels. In this review, we highlighted the RNA epitranscriptome pathways implicated in AS, describing their biological functions and their connections to the disease. The identification of epitranscriptome- sensitive pathways could provide novel opportunities to find predictive, diagnostic, and prognostic biomarkers for precision medicine.Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.