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Review
. 2022 Oct 5;30(10):3106-3117.
doi: 10.1016/j.ymthe.2022.08.024. Epub 2022 Sep 5.

Anti-atherosclerotic therapies: Milestones, challenges, and emerging innovations

Isabella Hetherington  1 , Hana Totary-Jain  2
Affiliations
Review

Anti-atherosclerotic therapies: Milestones, challenges, and emerging innovations

Isabella Hetherington et al. Mol Ther. .

Abstract

Atherosclerosis is the main underlying pathology for many cardiovascular diseases (CVDs), which are the leading cause of death globally and represent a serious health crisis. Atherosclerosis is a chronic condition that can lead to myocardial infarction, ischemic cardiomyopathy, stroke, and peripheral arterial disease. Elevated plasma lipids, hypertension, and high glucose are the major risk factors for developing atherosclerotic plaques. To date, most pharmacological therapies aim to control these risk factors, but they do not target the plaque-causing cells themselves. In patients with acute coronary syndromes, surgical revascularization with percutaneous coronary intervention has greatly reduced mortality rates. However, stent thrombosis and neo-atherosclerosis have emerged as major safety concerns of drug eluting stents due to delayed re-endothelialization. This review summarizes the major milestones, strengths, and limitations of current anti-atherosclerotic therapies. It provides an overview of the recent discoveries and emerging game-changing technologies in the fields of nanomedicine, mRNA therapeutics, and gene editing that have the potential to revolutionize CVD clinical practice by steering it toward precision medicine.

Keywords: atherosclerosis; base editing; cardiovascular disease; coronary artery disease; inflammation; mRNA therapeutics; miRNA-switch; nanomedicine; nanotherapy; precision medicine; stroke.

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Conflict of interest statement

Declaration of interests The authors declare no competing interests.

Figures

None
Graphical abstract
Figure 1
Figure 1
Atherosclerosis: Disease progression and risk factors Atherosclerosis begins with damage to the endothelium lining the arterial intima, initiated by risk factors. This leads to disease progression, lipid retention to the subendothelial space, infiltration of inflammatory cells, and plaque formation. Plaques can form over many decades without manifesting any symptoms but can lead to chronic ischemic heart disease or acute events such as plaque rupture, myocardial infarctions, and strokes. Made with Biorender.com.
Figure 2
Figure 2
Available anti-atherosclerotic drugs and interventions Made with Biorender.com.
See this image and copyright information in PMC

References

    1. Roth G.A., Mensah G.A., Johnson C.O., Addolorato G., Ammirati E., Baddour L.M., Barengo N.C., Beaton A.Z., Benjamin E.J., Benziger C.P., et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: update from the GBD 2019 study. J. Am. Coll. Cardiol. 2020;76:2982–3021. doi: 10.1016/j.jacc.2020.11.010. - DOI - PMC - PubMed
    1. Libby P., Buring J.E., Badimon L., Hansson G.K., Deanfield J., Bittencourt M.S., Tokgözoğlu L., Lewis E.F. Atherosclerosis. Nat. Rev. Dis. Primers. 2019;5:56. doi: 10.1038/s41572-019-0106-z. - DOI - PubMed
    1. Kronzon I., Tunick P.A. Aortic atherosclerotic disease and stroke. Circulation. 2006;114:63–75. doi: 10.1161/CIRCULATIONAHA.105.593418. - DOI - PubMed
    1. Libby P., Ridker P.M., Maseri A. Inflammation and atherosclerosis. Circulation. 2002;105:1135–1143. doi: 10.1161/hc0902.104353. - DOI - PubMed
    1. Campbell I.C., Suever J.D., Timmins L.H., Veneziani A., Vito R.P., Virmani R., Oshinski J.N., Taylor W.R. Biomechanics and inflammation in atherosclerotic plaque erosion and plaque rupture: implications for cardiovascular events in women. PLoS One. 2014;9:e111785. doi: 10.1371/journal.pone.0111785. - DOI - PMC - PubMed

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