Sympathetic Nervous System and Atherosclerosis

Area of Science:

• Cardiovascular Science
• Neuroscience
• Pharmacology

Background:

• Atherosclerosis, driven by lipid accumulation and hypercholesterolemia, is a primary global mortality cause.
• Despite lipid-lowering therapies, novel strategies are crucial due to atherosclerosis's persistent impact.
• The sympathetic nervous system is increasingly recognized for its significant role in atherosclerosis development.

Purpose of the Study:

• To review the role of sympathetic nervous system in atherosclerosis.
• To evaluate the therapeutic potential of adrenoceptor modulation and renal denervation for atherosclerosis.
• To synthesize current evidence on sympathetic pathways and their impact on arterial health.

Main Methods:

• Review of literature on sympathetic innervation, norepinephrine pathways, and sympathetic activation signaling.
• Analysis of studies investigating adrenoceptor antagonists/agonists (α1, α2, β1, β2, β3) in atherosclerosis models.
• Examination of research on renal denervation's effects on atherosclerosis.

Main Results:

• All five adrenoceptor subtypes (α1, α2, β1, β2, β3) are present in arterial blood vessels.
• α1 blockers show anti-atherosclerotic effects but risk heart failure; α2 agonism may offer protection.
• Newer β blockers and β3 agonists present promising therapeutic avenues, requiring further clinical validation.

Conclusions:

• Pharmacological targeting of specific adrenoceptors holds promise for atherosclerosis treatment.
• Further randomized controlled trials are essential to confirm the efficacy of these sympathetic-targeting therapies.
• The clinical benefit of renal denervation for atherosclerosis in humans remains undetermined.