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Endothelium as a Potential Target for Treatment of Abdominal Aortic Aneurysm

Abdominal aortic aneurysm (AAA) was previously ascribed to weaken defective medial arterial/adventitial layers, for example, smooth muscle/fibroblast cells. Therefore, besides surgical repair, medications targeting the medial layer to strengthen the aortic wall are the most feasible treatment strate...

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Autores principales: Sun, Jingyuan, Deng, Hongping, Zhou, Zhen, Xiong, Xiaoxing, Gao, Ling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903296/
https://www.ncbi.nlm.nih.gov/pubmed/29849906
http://dx.doi.org/10.1155/2018/6306542
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author Sun, Jingyuan
Deng, Hongping
Zhou, Zhen
Xiong, Xiaoxing
Gao, Ling
author_facet Sun, Jingyuan
Deng, Hongping
Zhou, Zhen
Xiong, Xiaoxing
Gao, Ling
author_sort Sun, Jingyuan
collection PubMed
description Abdominal aortic aneurysm (AAA) was previously ascribed to weaken defective medial arterial/adventitial layers, for example, smooth muscle/fibroblast cells. Therefore, besides surgical repair, medications targeting the medial layer to strengthen the aortic wall are the most feasible treatment strategy for AAA. However, so far, it is unclear whether such drugs have any beneficial effect on AAA prognosis, rate of aneurysm growth, rupture, or survival. Notably, clinical studies have shown that AAA is highly associated with endothelial dysfunction in the aged population. Additionally, animal models of endothelial dysfunction and endothelial nitric oxide synthase (eNOS) uncoupling had a very high rate of AAA formation, indicating there is crucial involvement of the endothelium and a possible pharmacological solution targeting the endothelium in AAA treatment. Endothelial cells have been found to trigger vascular wall remodeling by releasing proteases, or recruiting macrophages along with other neutrophils, into the medial layer. Moreover, inflammation and oxidative stress of the arterial wall were induced by endothelial dysfunction. Interestingly, there is a paradoxical differential correlation between diabetes and aneurysm formation in retinal capillaries and the aorta. Deciphering the significance of such a difference may explain current unsuccessful AAA medications and offer a solution to this treatment challenge. It is now believed that AAA and atherosclerosis are two separate but related diseases, based on their different clinical patterns which have further complicated the puzzle. Therefore, a thorough investigation of the interaction between endothelium and medial/adventitial layer may provide us a better understanding and new perspective on AAA formation, especially after taking into account the importance of endothelium in the development of AAA. Moreover, a novel medication strategy replacing the currently used, but suboptimal treatments for AAA, could be informed with this analysis.
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spelling pubmed-59032962018-05-30 Endothelium as a Potential Target for Treatment of Abdominal Aortic Aneurysm Sun, Jingyuan Deng, Hongping Zhou, Zhen Xiong, Xiaoxing Gao, Ling Oxid Med Cell Longev Review Article Abdominal aortic aneurysm (AAA) was previously ascribed to weaken defective medial arterial/adventitial layers, for example, smooth muscle/fibroblast cells. Therefore, besides surgical repair, medications targeting the medial layer to strengthen the aortic wall are the most feasible treatment strategy for AAA. However, so far, it is unclear whether such drugs have any beneficial effect on AAA prognosis, rate of aneurysm growth, rupture, or survival. Notably, clinical studies have shown that AAA is highly associated with endothelial dysfunction in the aged population. Additionally, animal models of endothelial dysfunction and endothelial nitric oxide synthase (eNOS) uncoupling had a very high rate of AAA formation, indicating there is crucial involvement of the endothelium and a possible pharmacological solution targeting the endothelium in AAA treatment. Endothelial cells have been found to trigger vascular wall remodeling by releasing proteases, or recruiting macrophages along with other neutrophils, into the medial layer. Moreover, inflammation and oxidative stress of the arterial wall were induced by endothelial dysfunction. Interestingly, there is a paradoxical differential correlation between diabetes and aneurysm formation in retinal capillaries and the aorta. Deciphering the significance of such a difference may explain current unsuccessful AAA medications and offer a solution to this treatment challenge. It is now believed that AAA and atherosclerosis are two separate but related diseases, based on their different clinical patterns which have further complicated the puzzle. Therefore, a thorough investigation of the interaction between endothelium and medial/adventitial layer may provide us a better understanding and new perspective on AAA formation, especially after taking into account the importance of endothelium in the development of AAA. Moreover, a novel medication strategy replacing the currently used, but suboptimal treatments for AAA, could be informed with this analysis. Hindawi 2018-04-03 /pmc/articles/PMC5903296/ /pubmed/29849906 http://dx.doi.org/10.1155/2018/6306542 Text en Copyright © 2018 Jingyuan Sun et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Sun, Jingyuan
Deng, Hongping
Zhou, Zhen
Xiong, Xiaoxing
Gao, Ling
Endothelium as a Potential Target for Treatment of Abdominal Aortic Aneurysm
title Endothelium as a Potential Target for Treatment of Abdominal Aortic Aneurysm
title_full Endothelium as a Potential Target for Treatment of Abdominal Aortic Aneurysm
title_fullStr Endothelium as a Potential Target for Treatment of Abdominal Aortic Aneurysm
title_full_unstemmed Endothelium as a Potential Target for Treatment of Abdominal Aortic Aneurysm
title_short Endothelium as a Potential Target for Treatment of Abdominal Aortic Aneurysm
title_sort endothelium as a potential target for treatment of abdominal aortic aneurysm
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5903296/
https://www.ncbi.nlm.nih.gov/pubmed/29849906
http://dx.doi.org/10.1155/2018/6306542
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