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Published on: August 20, 2019
Mechanisms of ET-1-induced endothelial dysfunction
1Actelion Pharmaceuticals Ltd., CH-4123 Allschwil, Switzerland. marc.iglarz@actelion.com
Insights
Endothelial dysfunction is an early sign of cardiovascular disease. Endothelin receptor antagonists show promise in correcting this dysfunction and improving cardiovascular health.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
Background:
- Endothelial dysfunction is an early indicator in cardiovascular disease pathophysiology.
- It predicts cardiovascular events in conditions like coronary artery disease, peripheral artery disease, and hypertension.
- Restoring endothelial function is a critical therapeutic target.
Purpose of the Study:
- To elucidate mechanisms of endothelin-1 (ET-1) induced endothelial dysfunction.
- To review pathological conditions linked to ET-1 related endothelial dysfunction.
- To synthesize evidence on endothelin receptor antagonists (ERAs) for endothelial function improvement.
Main Methods:
- Review of preclinical and clinical data.
- Analysis of proposed mechanisms of ET-1 action.
- Evidence synthesis on ERA efficacy.
Main Results:
- ET-1 contributes to endothelial dysfunction through various proposed mechanisms.
- Endothelial dysfunction is implicated in diverse cardiovascular pathologies.
- ERAs demonstrate potential in improving endothelial function.
Conclusions:
- Endothelin receptor antagonists represent a promising therapeutic class for endothelial dysfunction.
- Targeting ET-1 pathways may offer a novel approach to cardiovascular disease management.
- Further research into ERAs is warranted for various endothelial dysfunction-related diseases.
Abstract:
There is now increasing evidence that endothelial dysfunction is an early event in the pathophysiology of cardiovascular diseases and can be corrected with certain therapies such as angiotensin converting enzyme inhibitors angiotensin type I receptor antagonists and stains independently of blood pressure lowering effects. Restoring endothelial function appears to be a crucial target since endothelial dysfunction predicts cardiovascular events in various situations such as coronary artery disease peripheral artery disease, or hypertension and in patients undergoing vascular surgery. Preclinical and clinical data strongly support that endothelin receptor antagonists belong to this restricted class of pharmacological agents able to act on the endothelium, and offer a potential therapeutic approach for numerous diseases associated with endothelial dysfunction. The purpose of this review will be therefore, 1) to propose mechanisms by which ET-1 can cause endothelial dysfunction; 2) to provide an overview of pathological situations associated with endothelial dysfunction related to ET-1; and 3) to assemble evidence on efficacy of endothelin receptor antagonists for improvement of endothelial function.
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