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The arterial wall: a new pharmacological and therapeutic target
S Laurent1, P Vanhoutte, I Cavero
1Department of Pharmacology, Broussais University Hospital, Paris, France.
Insights
Endothelial dysfunction and arterial remodeling are key to cardiovascular diseases. New therapies target these processes, offering novel pharmacological strategies for conditions like hypertension and heart failure.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Pharmacology
Background:
- Endothelial dysfunction and arterial remodeling are interconnected concepts crucial for understanding cardiovascular diseases.
- These processes are implicated in pathologies such as essential hypertension, heart failure, atherosclerosis, restenosis, and pulmonary hypertension.
Purpose of the Study:
- To review the interrelationships between endothelial dysfunction and arterial remodeling.
- To discuss emerging pharmacological targets and therapeutic approaches for cardiovascular diseases based on these concepts.
Main Methods:
- Literature review focusing on the roles of endothelial dysfunction and arterial remodeling.
- Analysis of therapeutic strategies targeting specific cellular receptors, growth factors, and extracellular matrix components.
Main Results:
- Identified novel pharmacological targets including receptors on endothelial and smooth muscle cells, growth factors, and extracellular matrix enzymes.
- Discussed the therapeutic potential of angiotensin II receptor antagonists, endothelin receptor antagonists, nitrates-NO donors, potassium channel activators, and matrix-interfering substances.
Conclusions:
- Endothelial dysfunction and arterial remodeling represent critical targets for novel cardiovascular therapies.
- Pharmacological interventions modulating these processes offer promising avenues for managing diverse cardiovascular pathologies.
Abstract:
In recent years, two key concepts having numerous interrelationships were advanced for the understanding of various cardiovascular diseases: the "endothelial dysfunction" and the "arterial remodelling". Both endothelial dysfunction and arterial remodelling occur in various pathologies including essential hypertension, heart failure, atherosclerosis, restenosis after angioplasty, and pulmonary hypertension, and have modified the therapeutic approach by offering new pharmacological targets: specific receptors not only at the site of the vascular smooth muscle cells but also on the endothelial cells, growth factors that stimulate proliferation of smooth muscle, and receptors and enzymes of the extra-cellular matrix. Among the various substances under research, the present review will discuss angiotensin II receptor antagonists, endothelin receptor antagonists, nitrates-NO donors, potassium channel activators, and substances interfering with proteoglycans and other components of the extra-cellular matrix.