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Cardiovascular Research Advance Access [Accepted Manuscript] published online on May 19, 2009
Cardiovascular Research, doi:10.1093/cvr/cvp155
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org.

Pharmacological treatment of abdominal aortic aneurysm

Takashi Miyake and Ryuichi Morishita

Department of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, Osaka, Japan

Address correspondence to: Ryuichi Morishita, M.D., Ph.D., Division of Clinical Gene Therapy, Graduate School of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871, Japan +81-6-6879-3406 (phone), +81-6-6879-3409 (fax), E-mail: morishit{at}cgt.med.osaka-u.ac.jp

Abdominal aortic aneurysm (AAA) is a common degenerative condition with high mortality in older men. Elective surgical or endovascular repair is performed to prevent rupture of large AAAs. In contrast, despite gradual expansion, small AAAs have a low risk of rupture, and there is currently no well-defined treatment strategy for them. Therefore, a pharmacological approach for AAA is expected in the clinical setting. Indeed, several therapeutic effects of pharmacological agents have been reported in experimental models, and some agents have undergone clinical trials. Treatment with statins, angiotensin converting enzyme inhibitors, antibiotics and anti-inflammatory agents appears to inhibit the growth rate of AAA in humans. However, as the sample size and follow-up period were limited in these studies, a large randomized study with long-term follow-up of small AAA should be performed to clarify the effect of these agents. Recently, regression of AAA using molecular pharmacological approaches was reported in experimental studies. The characteristics of these strategies are regulation of multiple molecular mediators and the signaling networks associated with AAA formation. Based on the results of these investigations, it may be possible to repair the injured aortic wall and obtain remission of AAA using pharmacological therapy.

KEYWORDS Abdominal Aortic Aneurysm; Pharmacology; Decoy; NF{kappa}B; Ets

Time for primary review: 50 Days


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