Departmen of Biomedical Sciences, Humanitas University, Milan, Italy.
IRCCS Humanitas Research Hospital, Milan, Italy.
Expert Opin Ther Targets. 2022 Jul;26(7):633-644. doi: 10.1080/14728222.2022.2118576. Epub 2022 Sep 6.
Recommended therapy for calcific degenerative aortic stenosis (AS) is still aortic valve replacement (AVR), either transcatheter or surgical, since no conclusive efficacy has been determined in slowing the degenerative process by medical therapy.
This paper offers a brief overview of molecular mechanisms leading to calcification of aortic valve. It is then focused on potential markers of disease progression, as observed in many observational studies. Finally it provides a comprehensive review of drugs already tested in in vitro and human studies in order to slow aortic valve stenosis process.
Despite research providing numerous molecular pathways underlying the calcification process, further efforts must be made to understand risk factors linked to disease progression. Some existing treatments that have already provided survival benefits in many features of cardiovascular diseases are currently being tested with promising results. In the near future new drugs acting on specific pathways by techniques such as monoclonal antibodies and RNA interference, are expected to provide better medical solutions for this ever growing number of patients.
对于钙化性退行性主动脉瓣狭窄（AS），推荐的治疗方法仍然是主动脉瓣置换（AVR），无论是经导管还是手术，因为在药物治疗方面，还没有确定可以有效减缓退行性过程的结论。
本文简要概述了导致主动脉瓣钙化的分子机制。然后，重点介绍了在许多观察性研究中观察到的疾病进展的潜在标志物。最后，全面回顾了已经在体外和人体研究中测试过的药物，以减缓主动脉瓣狭窄的进程。
尽管研究提供了许多导致钙化过程的分子途径，但仍需要进一步努力来了解与疾病进展相关的风险因素。一些现有的治疗方法已经在许多心血管疾病的特征方面提供了生存获益，目前正在进行测试，结果令人鼓舞。在不久的将来，预计通过单克隆抗体和 RNA 干扰等技术作用于特定途径的新药将为这个不断增长的患者群体提供更好的医疗解决方案。
