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Nanoimmunotherapy to treat ischaemic heart disease
Raphaël Duivenvoorden1,2,3, Max L Senders4,5, Mandy M T van Leent4,5
1Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands. r.duivenvoorden@amc.uva.nl.
Insights
Atherosclerosis, a major cause of heart attack and stroke, is increasingly treated by targeting inflammation. Novel nanoimmunotherapies show promise for treating cardiovascular disease and preventing event recurrence.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Nanotechnology
Background:
- Atherosclerosis is a chronic inflammatory disease of large arteries, a leading cause of myocardial infarction and stroke.
- While lipid-lowering therapies are successful, atherosclerosis remains a significant global health threat.
- Recent advances focus on cardiovascular immunopathology, identifying inflammation as a key therapeutic target.
Purpose of the Study:
- To review the shift in therapeutic focus from lipids to inflammation in atherosclerosis treatment.
- To highlight the potential of nanotechnology in developing targeted immunomodulatory treatments.
- To discuss the challenges and future directions for nanoimmunotherapies in cardiovascular disease.
Main Methods:
- Review of clinical trial data, including the CANTOS trial, on anti-inflammatory therapies.
- Analysis of preclinical studies on nanotechnology for targeted immune cell modulation.
- Synthesis of current understanding of atherosclerosis immunopathology.
Main Results:
- The CANTOS trial demonstrated that Interleukin-1 beta (IL-1β) inhibition reduces cardiovascular event recurrence.
- Preclinical research indicates nanotechnology can specifically target innate immune cells for immunomodulation.
- These approaches offer potential for disease regression and prevention of recurrent cardiovascular events.
Conclusions:
- Targeting inflammation, exemplified by IL-1β inhibition, is a validated strategy for cardiovascular disease treatment.
- Nanoimmunotherapies represent a promising frontier for developing more effective treatments for atherosclerosis.
- Clinical translation of nanoimmunotherapies for ischaemic heart disease requires further research and development.
Abstract:
Atherosclerosis is a chronic disease of the large arteries and the underlying cause of myocardial infarction and stroke. Atherosclerosis is driven by cholesterol accumulation and subsequent inflammation in the vessel wall. Despite the clinical successes of lipid-lowering treatments, atherosclerosis remains one of the major threats to human health worldwide. Over the past 20 years, insights into cardiovascular immunopathology have provided a plethora of new potential therapeutic targets to reduce the risk of atherosclerosis and have shifted the therapeutic focus from lipids to inflammation. In 2017, the CANTOS trial demonstrated for the first time the beneficial effects of targeting inflammation to treat cardiovascular disease by showing that IL-1β inhibition can reduce the recurrence rate of cardiovascular events in a large cohort of patients. At the same time, preclinical studies have highlighted nanotechnology approaches that facilitate the specific targeting of innate immune cells, which could potentially generate more effective immunomodulatory treatments to induce disease regression and prevent the recurrence of cardiovascular events. The clinical translation of such nanoimmunotherapies and their application to treat patients with ischaemic heart disease are challenges that lie ahead.
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