Macrophage Polarization as a Novel Therapeutic Target for Endovascular Intervention in Peripheral Artery Disease
| Autor: | Steven G. Wise, David A. Robinson, Yuen Ting Lam, Isabelle Ryder, Martin K.C. Ng, Miguel Santos, Richard P. Tan, Nianji Yang, Praveesuda L. Michael |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
BMS bare-metal stent Arterial disease macrophage polarization CAD coronary artery disease medicine.medical_treatment Macrophage polarization endovascular intervention Inflammation Disease paclitaxel chemistry.chemical_compound Quality of life peripheral arterial disease SFA superficial femoral artery Intervention (counseling) drug-eluting stent medicine vascular inflammation DES drug-eluting stent FP femoropopliteal TGF transforming growth factor PAD peripheral artery disease TNF tumor necrosis factor business.industry vascular healing IL interleukin Surgery drug-eluting balloon PTA percutaneous transluminal angioplasty Paclitaxel chemistry Drug-eluting stent State-of-the-Art Review MI myocardial infarction medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC: Basic to Translational Science |
| ISSN: | 2452-302X |
| DOI: | 10.1016/j.jacbts.2021.04.008 |
| Popis: | Highlights • Revascularization for PAD has been characterized by the adaptation of technologies from the treatment of CAD, with few therapies specifically developed for PAD. • In light of recent increases in all-cause mortality driven by endovascular PAD interventions that employ elution of antiproliferative agents, this review highlights the unmet need to address underlying local inflammation and proposes an alternative therapeutic approach. • Development of next-generation PAD-specific endovascular interventions will benefit from integration of specialized immunotherapies that target macrophage polarization and focus on vessel healing. Summary Peripheral artery disease (PAD) has a significant impact on human health, affecting 200 million people globally. Advanced PAD severely diminishes quality of life, affecting mobility, and in its most severe form leads to limb amputation and death. Treatment of PAD is among the least effective of all endovascular procedures in terms of long-term efficacy. Chronic inflammation is a key driver of PAD; however, stents and coated balloons eluting antiproliferative drugs are most commonly used. As a result, neither stents nor coated balloons produce durable clinical outcomes in the superficial femoral artery, and both have recently been associated with significantly increased mortality. This review summarizes the most common clinical approaches and limitations to treating PAD and highlights the necessity to address the underlying causes of inflammation, identifying macrophages as a novel therapeutic target in the next generation of endovascular PAD intervention. Central Illustration |
| Databáze: | OpenAIRE |
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