Liu Yan, Lu Kuan, Zhang Ruru, Hu Dongliang, Yang Zhe, Zeng Jianfeng, Cai Wu
The Second Affiliated Hospital of Soochow University, Suzhou, 215000, China.
Center for Molecular Imaging and Nuclear Medicine, State Key Laboratory of Radiation Medicine and Protection, School for Radiological and Interdisciplinary Sciences (RAD-X), Collaborative Innovation Center of Radiological Medicine of Jiangsu Higher Education Institutions, Soochow University, Suzhou, 215123, China.
ACS Pharmacol Transl Sci. 2024 Dec 4;7(12):3804-3826. doi: 10.1021/acsptsci.4c00574. eCollection 2024 Dec 13.
Atherosclerosis is a leading cause of morbidity and mortality worldwide, driven by a complex interplay of lipid dysregulation, inflammation, and vascular pathology. Despite advancements in understanding the multifactorial nature of atherosclerosis and improvements in clinical management, existing therapies often fall short in reversing the disease, focusing instead on symptom alleviation and risk reduction. This review highlights recent strides in identifying genetic markers, elucidating inflammatory pathways, and understanding environmental contributors to atherosclerosis. It also evaluates the efficacy and limitations of current pharmacological treatments, revascularization techniques, and the impact of these interventions on patient outcomes. Furthermore, we explore innovative therapeutic strategies, including the promising fields of nanomedicine, nucleic acid-based therapies, and immunomodulation, which offer potential for targeted and effective treatment modalities. However, integrating these advances into clinical practice is challenged by regulatory, economic, and logistical barriers. This review synthesizes the latest research and clinical advancements to provide a comprehensive roadmap for future therapeutic strategies and emphasize the critical need for innovative approaches to fundamentally change the course of atherosclerosis management.
动脉粥样硬化是全球发病和死亡的主要原因,由脂质代谢失调、炎症和血管病变的复杂相互作用驱动。尽管在理解动脉粥样硬化的多因素性质以及临床管理方面取得了进展,但现有疗法往往在逆转疾病方面效果不佳,而是侧重于缓解症状和降低风险。本综述重点介绍了在识别遗传标记、阐明炎症途径以及了解动脉粥样硬化的环境影响因素方面的最新进展。它还评估了当前药物治疗、血管重建技术的疗效和局限性,以及这些干预措施对患者预后的影响。此外,我们探索了创新的治疗策略,包括纳米医学、基于核酸的疗法和免疫调节等有前景的领域,这些领域为靶向和有效的治疗方式提供了潜力。然而,将这些进展整合到临床实践中面临着监管、经济和后勤方面的障碍。本综述综合了最新的研究和临床进展,为未来的治疗策略提供了全面的路线图,并强调了创新方法从根本上改变动脉粥样硬化管理进程的迫切需求。