Stougiannou Theodora M, Christodoulou Konstantinos C, Georgakarakos Efstratios, Mikroulis Dimitrios, Karangelis Dimos
Department of Cardiothoracic Surgery, University General Hospital of Alexandroupolis, Dragana, 68100 Alexandroupolis, Greece.
J Clin Med. 2023 Sep 10;12(18):5878. doi: 10.3390/jcm12185878.
Aortic and visceral aneurysms affect large arterial vessels, including the thoracic and abdominal aorta, as well as visceral arterial branches, such as the splenic, hepatic, and mesenteric arteries, respectively. Although these clinical entities have not been equally researched, it seems that they might share certain common pathophysiological changes and molecular mechanisms. The yet limited published data, with regard to newly designed, novel therapies, could serve as a nidus for the evaluation and potential implementation of such treatments in large artery aneurysms. In both animal models and clinical trials, various novel treatments have been employed in an attempt to not only reduce the complications of the already implemented modalities, through manufacturing of more durable materials, but also to regenerate or replace affected tissues themselves. Cellular populations like stem and differentiated vascular cell types, large diameter tissue-engineered vascular grafts (TEVGs), and various molecules and biological factors that might target aspects of the pathophysiological process, including cell-adhesion stabilizers, metalloproteinase inhibitors, and miRNAs, could potentially contribute significantly to the treatment of these types of aneurysms. In this narrative review, we sought to collect and present relevant evidence in the literature, in an effort to unveil promising biological therapies, possibly applicable to the treatment of aortic aneurysms, both thoracic and abdominal, as well as visceral aneurysms.
主动脉瘤和内脏动脉瘤累及大的动脉血管,包括胸主动脉和腹主动脉,以及内脏动脉分支,如脾动脉、肝动脉和肠系膜动脉。尽管对这些临床实体的研究程度不尽相同,但它们似乎可能存在某些共同的病理生理变化和分子机制。关于新设计的新型疗法,目前已发表的数据有限,这些数据可作为评估和在大动脉动脉瘤中潜在实施此类治疗的基础。在动物模型和临床试验中,已采用了各种新型治疗方法,不仅试图通过制造更耐用的材料来减少现有治疗方式的并发症,还试图再生或替换受影响的组织本身。细胞群体,如干细胞和分化的血管细胞类型、大口径组织工程血管移植物(TEVG),以及可能针对病理生理过程各个方面的各种分子和生物因子,包括细胞粘附稳定剂、金属蛋白酶抑制剂和微小RNA,可能对这些类型的动脉瘤治疗有显著贡献。在这篇叙述性综述中,我们试图收集并展示文献中的相关证据,以揭示可能适用于治疗胸主动脉瘤、腹主动脉瘤以及内脏动脉瘤的有前景的生物疗法。