Targeting Atherosclerosis via NEDD4L Signaling-A Review of the Current Literature

Cardiovascular diseases are the primary cause of mortality worldwide. In this scenario, atherosclerotic cardiovascular outcomes dominate since their incidence increases as populations grow and age. Atherosclerosis is a chronic inflammatory disease that affects arteries. Although its pathophysiology is heterogeneous, some genes are indissociably associated with its occurrence, and understanding their effects on the disease's occurrence could undoubtedly define effective screening and treatment strategies. One such gene is NEDD4L. The NEDD4L gene is related to ubiquitin ligase enzyme activities. It is essential to regulate vascular inflammation, atherosclerosis plaque stability, endothelial and vascular smooth cell function, and lipid metabolism, particularly in controlling cholesterol levels. However, the evidence is dubious, and no review has yet synthesized the effects of targeting NEDD4L on atherosclerosis. Therefore, our review aims to fill this gap by analyzing the literature on NEDD4L concerning atherosclerosis occurrence. To achieve this goal, we performed a systematic literature search of reputable databases, including PubMed, Google Scholar, Web of Science, Scopus, and Embase. The inclusion criteria comprised peer-reviewed original studies using in vitro and animal models due to the unavailability of relevant clinical studies. Systematic reviews, meta-analyses, and articles that did not focus on the relationship between NEDD4L and atherosclerosis and those unrelated to this health condition were excluded. Studies not written in the English language were also excluded. The search strategy included studies from January 2000 to January 2025 in the final analysis to capture recent advancements. Following screening, five studies were included. Most of the included studies underscored NEDD4L's role in increasing atherosclerosis plaque formation, but other studies indicated that stimulating NEDD4L may positively counter atherosclerosis plaque formation. Therefore, future research endeavors must address several limitations, which have been tentatively highlighted throughout the manuscript, for more informative research based on preclinical studies and to successfully translate the findings into clinical trials.