Yoshimura Koichi, Aoki Hiroki
Department of Surgery and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami Kogushi, Ube, Yamaguchi 755-8505, Japan.
Int J Vasc Med. 2012;2012:648167. doi: 10.1155/2012/648167. Epub 2012 Aug 21.
Abdominal aortic aneurysm (AAA) is a common disease causing segmental expansion and rupture of the aorta with a high mortality rate. The lack of nonsurgical treatment represents a large and unmet need in terms of pharmacotherapy. Advances in AAA research revealed that activation of inflammatory signaling pathways through proinflammatory mediators shifts the balance of extracellular matrix (ECM) metabolism toward tissue degradation. This idea is supported by experimental evidence in animal models that pharmacologic intervention at each pathological step can prevent AAA development. Previously, we identified c-Jun N-terminal kinase (JNK), a pro-inflammatory signaling molecule, as a therapeutic target for AAA. Abnormal activation of JNK in AAA tissue regulates multiple pathological processes in a coordinated manner. Pharmacologic inhibition of JNK tips the ECM balance back towards repair rather than degradation. Interventions targeting signaling molecules such as JNK in order to manipulate multiple pathological processes may be an ideal therapeutic strategy for AAA. Furthermore, the development of biomarkers as well as appropriate drug delivery systems is essential to produce clinically practical pharmacotherapy for AAA.
腹主动脉瘤(AAA)是一种常见疾病,可导致主动脉节段性扩张和破裂,死亡率很高。在药物治疗方面,缺乏非手术治疗方法代表了一个巨大且未得到满足的需求。AAA研究的进展表明,通过促炎介质激活炎症信号通路会使细胞外基质(ECM)代谢平衡朝着组织降解方向转变。动物模型中的实验证据支持了这一观点,即在每个病理步骤进行药物干预都可以预防AAA的发展。此前,我们确定c-Jun氨基末端激酶(JNK),一种促炎信号分子,为AAA的治疗靶点。AAA组织中JNK的异常激活以协调的方式调节多种病理过程。对JNK的药物抑制可使ECM平衡向修复而非降解方向转变。针对JNK等信号分子进行干预以操控多种病理过程可能是AAA的理想治疗策略。此外,开发生物标志物以及合适的药物递送系统对于产生临床上实用的AAA药物治疗至关重要。