Lastly, downregulated lncRNA, protein kinase C alpha antisense RNA 1 (PRKCA-AS1) decreases DNMT1-mediated methylation (Figure 5) of the promoter region of protein kinase C alpha (PRKCA), and subsequently increases PRKCA expression in the mitral valves of patients with rheumatic heart disease, suggesting a DNMT-regulated mechanism in valvular heart disease [141]. Here, DNMT1 is linked to rheumatic heart disease.