Emerging Anti-Atherosclerotic Therapies

Int J Mol Sci. 2021 Nov 9;22(22):12109. doi: 10.3390/ijms222212109.

Abstract

Cardiovascular disease (CAD) is the main cause of morbidity and deaths in the western world. The development of atherosclerosis underlying CAD development begins early in human life. There are numerous genetic and environmental risk factors accelerating its progression which then leads to the occurrence of acute events. Despite considerable progress in determining risk factors, there is still a lot of work ahead since identified determinants are responsible only for a part of overall CAD risk. Current therapies are insufficient to successfully reduce the risk of atherosclerosis development. Therefore, there is a need for effective preventive measures of clinical manifestations of atherosclerosis since the currently available drugs cannot prevent the occurrence of even 70% of clinical events. The shift of the target from lipid metabolism has opened the door to many new therapeutic targets. Currently, the majority of known targets for anti-atherosclerotic drugs focus also on inflammation (a common mediator of many risk factors), mechanisms of innate and adaptive immunity in atherosclerosis, molecule scavengers, etc. The therapeutic potential of cyclodextrins, protein kinase inhibitors, colchicine, inhibitors of p38 mitogen-activated protein kinase (MAPK), lipid dicarbonyl scavengers, a monoclonal antibody targeting interleukin-1β, and P-selectin inhibitors is still not fully confirmed and requires confirmation in large clinical trials. The preliminary results look promising.

Keywords: P-selectin inhibitors; atherosclerosis; colchicine; cyclodextrins; inhibitors of p38 mitogen-activated protein kinase (MAPK); lipid dicarbonyl scavengers; monoclonal antibody targeting interleukin-1β; protein kinase inhibitors.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity / drug effects*
  • Adaptive Immunity / genetics
  • Anti-Inflammatory Agents / therapeutic use
  • Atherosclerosis / drug therapy*
  • Atherosclerosis / immunology
  • Atherosclerosis / pathology
  • Cardiovascular Diseases / drug therapy
  • Cardiovascular Diseases / genetics
  • Cardiovascular Diseases / pathology
  • Colchicine / therapeutic use
  • Humans
  • Immunity, Innate / drug effects*
  • Immunity, Innate / genetics
  • Inflammation / drug therapy*
  • Inflammation / immunology
  • Inflammation / pathology
  • Interleukin-1beta / antagonists & inhibitors
  • Interleukin-1beta / genetics
  • P-Selectin / antagonists & inhibitors
  • P-Selectin / genetics
  • Risk Factors
  • p38 Mitogen-Activated Protein Kinases / antagonists & inhibitors
  • p38 Mitogen-Activated Protein Kinases / genetics

Substances

  • Anti-Inflammatory Agents
  • IL1B protein, human
  • Interleukin-1beta
  • P-Selectin
  • p38 Mitogen-Activated Protein Kinases
  • Colchicine