Cargando…

Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment

Thoracic aortic aneurysms (TAAs) are permanent pathological dilatations of the thoracic aorta, which can lead to life-threatening complications, such as aortic dissection and rupture. TAAs frequently occur in a syndromic form in individuals with an underlying genetic predisposition, such as Marfan s...

Descripción completa

Detalles Bibliográficos
Autores principales: van Dorst, Daan C.H., de Wagenaar, Nathalie P., van der Pluijm, Ingrid, Roos-Hesselink, Jolien W., Essers, Jeroen, Danser, A.H. Jan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578102/
https://www.ncbi.nlm.nih.gov/pubmed/33283255
http://dx.doi.org/10.1007/s10557-020-07116-4
_version_ 1784596205684129792
author van Dorst, Daan C.H.
de Wagenaar, Nathalie P.
van der Pluijm, Ingrid
Roos-Hesselink, Jolien W.
Essers, Jeroen
Danser, A.H. Jan
author_facet van Dorst, Daan C.H.
de Wagenaar, Nathalie P.
van der Pluijm, Ingrid
Roos-Hesselink, Jolien W.
Essers, Jeroen
Danser, A.H. Jan
author_sort van Dorst, Daan C.H.
collection PubMed
description Thoracic aortic aneurysms (TAAs) are permanent pathological dilatations of the thoracic aorta, which can lead to life-threatening complications, such as aortic dissection and rupture. TAAs frequently occur in a syndromic form in individuals with an underlying genetic predisposition, such as Marfan syndrome (MFS) and Loeys-Dietz syndrome (LDS). Increasing evidence supports an important role for transforming growth factor-β (TGF-β) and the renin-angiotensin system (RAS) in TAA pathology. Eventually, most patients with syndromic TAAs require surgical intervention, as the ability of present medical treatment to attenuate aneurysm growth is limited. Therefore, more effective medical treatment options are urgently needed. Numerous clinical trials investigated the therapeutic potential of angiotensin receptor blockers (ARBs) and β-blockers in patients suffering from syndromic TAAs. This review highlights the contribution of TGF-β signaling, RAS, and impaired mechanosensing abilities of aortic VSMCs in TAA formation. Furthermore, it critically discusses the most recent clinical evidence regarding the possible therapeutic benefit of ARBs and β-blockers in syndromic TAA patients and provides future research perspectives and therapeutic implications.
format Online
Article
Text
id pubmed-8578102
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Springer US
record_format MEDLINE/PubMed
spelling pubmed-85781022021-11-15 Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment van Dorst, Daan C.H. de Wagenaar, Nathalie P. van der Pluijm, Ingrid Roos-Hesselink, Jolien W. Essers, Jeroen Danser, A.H. Jan Cardiovasc Drugs Ther Invited Review Article Thoracic aortic aneurysms (TAAs) are permanent pathological dilatations of the thoracic aorta, which can lead to life-threatening complications, such as aortic dissection and rupture. TAAs frequently occur in a syndromic form in individuals with an underlying genetic predisposition, such as Marfan syndrome (MFS) and Loeys-Dietz syndrome (LDS). Increasing evidence supports an important role for transforming growth factor-β (TGF-β) and the renin-angiotensin system (RAS) in TAA pathology. Eventually, most patients with syndromic TAAs require surgical intervention, as the ability of present medical treatment to attenuate aneurysm growth is limited. Therefore, more effective medical treatment options are urgently needed. Numerous clinical trials investigated the therapeutic potential of angiotensin receptor blockers (ARBs) and β-blockers in patients suffering from syndromic TAAs. This review highlights the contribution of TGF-β signaling, RAS, and impaired mechanosensing abilities of aortic VSMCs in TAA formation. Furthermore, it critically discusses the most recent clinical evidence regarding the possible therapeutic benefit of ARBs and β-blockers in syndromic TAA patients and provides future research perspectives and therapeutic implications. Springer US 2020-12-07 2021 /pmc/articles/PMC8578102/ /pubmed/33283255 http://dx.doi.org/10.1007/s10557-020-07116-4 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Invited Review Article
van Dorst, Daan C.H.
de Wagenaar, Nathalie P.
van der Pluijm, Ingrid
Roos-Hesselink, Jolien W.
Essers, Jeroen
Danser, A.H. Jan
Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment
title Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment
title_full Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment
title_fullStr Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment
title_full_unstemmed Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment
title_short Transforming Growth Factor-β and the Renin-Angiotensin System in Syndromic Thoracic Aortic Aneurysms: Implications for Treatment
title_sort transforming growth factor-β and the renin-angiotensin system in syndromic thoracic aortic aneurysms: implications for treatment
topic Invited Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578102/
https://www.ncbi.nlm.nih.gov/pubmed/33283255
http://dx.doi.org/10.1007/s10557-020-07116-4
work_keys_str_mv AT vandorstdaanch transforminggrowthfactorbandthereninangiotensinsysteminsyndromicthoracicaorticaneurysmsimplicationsfortreatment
AT dewagenaarnathaliep transforminggrowthfactorbandthereninangiotensinsysteminsyndromicthoracicaorticaneurysmsimplicationsfortreatment
AT vanderpluijmingrid transforminggrowthfactorbandthereninangiotensinsysteminsyndromicthoracicaorticaneurysmsimplicationsfortreatment
AT rooshesselinkjolienw transforminggrowthfactorbandthereninangiotensinsysteminsyndromicthoracicaorticaneurysmsimplicationsfortreatment
AT essersjeroen transforminggrowthfactorbandthereninangiotensinsysteminsyndromicthoracicaorticaneurysmsimplicationsfortreatment
AT danserahjan transforminggrowthfactorbandthereninangiotensinsysteminsyndromicthoracicaorticaneurysmsimplicationsfortreatment