Current Status and Perspectives on Pharmacologic Therapy for Abdominal Aortic Aneurysm

Abstract

Background: Abdominal aortic aneurysm (AAA), a common disease involving the segmen-tal expansion and rupture of the aorta, has a high mortality rate. Therapeutic options for AAA are cur-rently limited to surgical repair to prevent catastrophic rupture. Non-surgical approaches, particularly pharmacotherapy, are lacking for the treatment of AAA.Objective: We review both basic and clinical studies and discuss the current challenges to developing medical therapy that reduces AAA progression.Results: Studies using animal models of AAA progression and human AAA explant cultures have identified several potential targets for preventing AAA growth. However, no clinical studies have con-vincingly confirmed the efficacy of any pharmacologic treatment against the growth of AAA. Thus, there is as yet no strong recommendation regarding pharmacotherapy to reduce the risk of AAA pro-gression and rupture.Conclusion: This review identifies concerns that need to be addressed for the field to progress and dis-cusses the challenges that must be overcome in order to develop effective pharmacotherapy to reduce AAA progression in the future.

A selective antagonist of prostaglandin E receptor subtype 4 attenuates abdominal aortic aneurysm

“…Vascular inflammation is a prominent feature of atherosclerotic AAA (Yoshimura et al. ). We examined IL‐6 protein expression in angiotensin II‐induced AAA in ApoE −/− mice.…”

“…CJ-42794 treatment decreased IL-6 proteins in angiotensin II-induced AAA Vascular inflammation is a prominent feature of atherosclerotic AAA (Yoshimura et al 2018). We examined IL-6 protein expression in angiotensin II-induced AAA in ApoE À/À mice.…”

“…AAA is thought to have many different causes, such as hemodynamic stress, aging, and smoking, and subsequent immune and inflammatory responses induce extracellular matrix degradation and vascular smooth muscle cell dysfunction, resulting in AAA progression (Yoshimura et al. ). Extensive study using animals with or without genetic modification combined with angiotensin II, elastase, or CaCl 2 applications revealed potential molecules to target various aspects of the AAA pathological processes (Yoshimura et al.…”

“…Extensive study using animals with or without genetic modification combined with angiotensin II, elastase, or CaCl 2 applications revealed potential molecules to target various aspects of the AAA pathological processes (Yoshimura et al. ). Current animal models of AAA have the following two disease phases: a model‐specific initial developmental phase and a progression phase, which is similar to human pathology (Lysgaard Poulsen et al.…”

“…Although a large number of reports identified potential therapeutic targets to treat patients with AAA, a limited number of them focused on the progression phase in in vivo animal models, and in particular, few used human AAA samples (Yoshimura et al. ). In the present study, besides the inhibitory effect of CJ‐42794 on AAA formation, we investigated the effect of CJ‐42794 on the progression phase.…”