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Endothelin and the Cardiovascular System: The Long Journey and Where We Are Going
Andreas Haryono1,2, Risa Ramadhiani2, Gusty Rizky Teguh Ryanto2
1Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan.
Insights
The endothelin system plays a key role in cardiovascular diseases like hypertension. Endothelin receptor antagonists show varying success in treatment, with future therapies on the horizon.
Area of Science:
- Cardiovascular Medicine
- Endocrinology
- Pharmacology
Background:
- Endothelin, a potent vasoconstrictor, was discovered over 30 years ago.
- The endothelin system comprises three isoforms, two receptors, and two enzymes, crucial in cardiovascular physiology.
- Dysregulation of the endothelin system is implicated in hypertension, pulmonary arterial hypertension, heart failure, and coronary artery disease.
Purpose of the Study:
- To review current knowledge on the endothelin system's role in cardiovascular diseases.
- To discuss the efficacy and limitations of current endothelin-targeting therapies.
- To explore future directions for endothelin-based treatments in cardiovascular medicine.
Main Methods:
- Comprehensive literature review of preclinical and clinical studies.
- Analysis of the pathogenesis of cardiovascular diseases linked to the endothelin system.
- Evaluation of the clinical outcomes of endothelin receptor antagonists.
Main Results:
- The endothelin system is a critical factor in the development of major cardiovascular conditions.
- Endothelin receptor antagonists have demonstrated varying degrees of therapeutic success.
- Significant research has elucidated the basic functions and pathological roles of endothelin.
Conclusions:
- The endothelin system is a validated therapeutic target for cardiovascular diseases.
- Further research is needed to optimize endothelin-targeting therapies for improved patient outcomes.
- Future strategies may involve novel approaches to modulate the endothelin pathway.
Abstract:
Endothelin was first discovered more than 30 years ago as a potent vasoconstrictor. In subsequent years, three isoforms, two canonical receptors, and two converting enzymes were identified, and their basic functions were elucidated by numerous preclinical and clinical studies. Over the years, the endothelin system has been found to be critical in the pathogenesis of several cardiovascular diseases, including hypertension, pulmonary arterial hypertension, heart failure, and coronary artery disease. In this review, we summarize the current knowledge on endothelin and its role in cardiovascular diseases. Furthermore, we discuss how endothelin-targeting therapies, such as endothelin receptor antagonists, have been employed to treat cardiovascular diseases with varying degrees of success. Lastly, we provide a glimpse of what could be in store for endothelin-targeting treatment options for cardiovascular diseases in the future.
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