Chao Calvin L, Applewhite Brandon, Reddy Nidhi K, Matiuto Natalia, Dang Caitlyn, Jiang Bin
Division of Vascular Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, United States.
Department of Biomedical Engineering, Northwestern University McCormick School of Engineering, Chicago, IL, United States.
Front Cardiovasc Med. 2024 Jun 4;11:1369785. doi: 10.3389/fcvm.2024.1369785. eCollection 2024.
Abdominal aortic aneurysm (AAA) is a significant source of mortality worldwide and carries a mortality of greater than 80% after rupture. Despite extensive efforts to develop pharmacological treatments, there is currently no effective agent to prevent aneurysm growth and rupture. Current treatment paradigms only rely on the identification and surveillance of small aneurysms, prior to ultimate open surgical or endovascular repair. Recently, regenerative therapies have emerged as promising avenues to address the degenerative changes observed in AAA. This review briefly outlines current clinical management principles, characteristics, and pharmaceutical targets of AAA. Subsequently, a thorough discussion of regenerative approaches is provided. These include cellular approaches (vascular smooth muscle cells, endothelial cells, and mesenchymal stem cells) as well as the delivery of therapeutic molecules, gene therapies, and regenerative biomaterials. Lastly, additional barriers and considerations for clinical translation are provided. In conclusion, regenerative approaches hold significant promise for reversal of tissue damages in AAA, necessitating sustained research and innovation to achieve successful and translatable therapies in a new era in AAA management.
腹主动脉瘤(AAA)是全球范围内一个重要的死亡原因,破裂后死亡率超过80%。尽管人们为开发药物治疗付出了巨大努力,但目前尚无有效的药物来预防动脉瘤的生长和破裂。目前的治疗模式仅依赖于在最终进行开放手术或血管内修复之前,对小动脉瘤进行识别和监测。最近,再生疗法已成为解决腹主动脉瘤中观察到的退行性变化的有前景的途径。本文简要概述了腹主动脉瘤当前的临床管理原则、特征和药物靶点。随后,对再生方法进行了深入讨论。这些方法包括细胞方法(血管平滑肌细胞、内皮细胞和间充质干细胞)以及治疗分子的递送、基因治疗和再生生物材料。最后,还提供了临床转化的其他障碍和注意事项。总之,再生方法在逆转腹主动脉瘤组织损伤方面具有巨大潜力,需要持续的研究和创新,以在腹主动脉瘤管理的新时代实现成功且可转化的治疗。