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腹主动脉瘤再生疗法的进展与挑战

Advances and challenges in regenerative therapies for abdominal aortic aneurysm.

作者信息

Chao Calvin L, Applewhite Brandon, Reddy Nidhi K, Matiuto Natalia, Dang Caitlyn, Jiang Bin

机构信息

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.

出版信息

Front Cardiovasc Med. 2024 Jun 4;11:1369785. doi: 10.3389/fcvm.2024.1369785. eCollection 2024.

DOI:10.3389/fcvm.2024.1369785
PMID:38895536
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11183335/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/91bef73c7a5d/fcvm-11-1369785-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/c50149dab261/fcvm-11-1369785-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/3756ee128fe3/fcvm-11-1369785-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/58e16f0e3b9a/fcvm-11-1369785-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/bcfb474063ff/fcvm-11-1369785-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/91bef73c7a5d/fcvm-11-1369785-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/c50149dab261/fcvm-11-1369785-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/3756ee128fe3/fcvm-11-1369785-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/58e16f0e3b9a/fcvm-11-1369785-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/bcfb474063ff/fcvm-11-1369785-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/372c/11183335/91bef73c7a5d/fcvm-11-1369785-g005.jpg

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J Vasc Surg. 2023 Oct;78(4):929-935.e1. doi: 10.1016/j.jvs.2023.05.056. Epub 2023 Jun 15.
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The contribution of databases towards understanding the universe of long non-coding RNAs.
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J Pers Med. 2024 Dec 10;14(12):1148. doi: 10.3390/jpm14121148.
数据库在理解长链非编码RNA领域中的作用。
Nat Rev Mol Cell Biol. 2023 Sep;24(9):601-602. doi: 10.1038/s41580-023-00612-z.
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Mesenchymal stem cell-derived extracellular vesicles protect against abdominal aortic aneurysm formation by inhibiting NET-induced ferroptosis.间质干细胞衍生的细胞外囊泡通过抑制 NET 诱导的铁死亡来防止腹主动脉瘤形成。
Exp Mol Med. 2023 May;55(5):939-951. doi: 10.1038/s12276-023-00986-2. Epub 2023 May 1.
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Surface-Functionalized Stem Cell-Derived Extracellular Vesicles for Vascular Elastic Matrix Regenerative Repair.表面功能化的干细胞衍生细胞外囊泡用于血管弹性基质再生修复。
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