A Novel circRERE/miR-27a-3p/Caspase9 Signaling Axis Promotes Cardiomyocyte Apoptosis in Ischemic Myocardium: Insights from Epigallocatechin Gallate-Primed Exosomes

Acute myocardial infarction (AMI) causes high mortality, with cardiomyocyte apoptosis playing a critical role. Although circular RNAs modulate cardiac disorders, related mechanisms remain unclear. Here, we identify circRERE as a previously unrecognized pro-apoptotic regulator under ischemic stress. circRERE is markedly upregulated in ischemic myocardium and promotes apoptosis by sponging miR-27a-3p to elevate Caspase9. Using epigallocatechin gallate-primed exosomes (EGCG-primed exosomes, ExoEGCG) as a tool to modulate circRERE, we found that ExoEGCG significantly reduced circRERE levels, restored miR-27a-3p activity, and suppressed Caspase9. Gain- and loss-of-function tests confirmed that circRERE mediates ExoEGCG-derived protection. Collectively, circRERE represents a novel and actionable target for AMI, with ExoEGCG serving as an effective delivery platform.