Molecular targets in aortic aneurysm for establishing novel management paradigms

Abstract

Aortic aneurysm (AA) is a lethal disease and presents a large challenge for surgeons in the clinic.Although surgical management remains the major choice of AA, operative mortality remains high. With advances in understanding of the mechanisms of AAs, molecular targets, such as matrix metalloproteinases (MMPs), D-dimer, and inflammation markers, including C-reactive protein, interleukins and phagocytes, are important in the pathology of development of AA. These markers may become important for improving the diagnostic quality and provide more therapeutic choices for treatment of AA. Although these new markers require long-term trials before they can be translated into the clinic, they can still be helpful in determining new directions. The main aim of this review is to discuss the current findings of molecular targets in progression of AA and discuss the potential application of these new targets for managing this disease.

Using Molecular Targets to Predict and Treat Aortic Aneurysms

“…Recent evidence has shown that apoptosis is another vital process in the pathogenesis of AAs [ 84 , 85 ]. VSMC is the main effector cell constituting the aorta tunica media and play an essential role in maintaining vascular wall structure and function [ 86 ]. Several studies have demonstrated that the inflammatory cells induce apoptosis and MMP synthesis [ 42 ].…”

Predictions and insights for the abdominal aortic aneurysm

“…In a holistic approach, every single study concerning the physiology of AAAs is welcome; in clinical praxis prediction is required for the individualization of treatment. However, the scientific challenge for AAAs is, following an early detection of an aorta with a propensity for dilatation or with a small aneurysm-U/S studies consist a realistic methodto identify with the proper detecting molecules all the metabolic pathways of the disease, by tracking alterations in molecular level at the microenvironment of the aortic tissue (15). Then, by using the same detectors as vectors, or through other medical solutions, we have to modify the aortic wall by remodeling and enhancing the up regulation of the strengthening matrix components, with the aim to interrupt and reverse this hostile biological irregularity at an early stage.…”

Thrombospondins in human aortic aneurysms

“…In addition, while some TAA are associated with an inflammatory state, this does not always happen 6 . Finally, extracellular matrix (ECM) degradation has been evidenced in TAA and AAA, 7 playing pivotal roles in the pathology.…”