摘要
目的:本次综述为正在进行的随机对照试验评估非诺贝特和替米沙坦对限制腹主动脉瘤(AAA)生长的有效性提供了理论和最新进展。 方法/结果:目前迫切需要寻找一种限制AAA生长的药物治疗,临床前和人类研究表明,非诺贝特和替米沙坦具有延缓主动脉破坏的潜力,非诺贝特可降低血清和组织中促炎蛋白骨桥蛋白的水平,减少巨噬细胞向主动脉壁的吸收,这两者都是AAA发生和发展的重要过程。替米沙坦通过阻断血管紧张素II受体1型,并作为过氧化物酶体增殖物激活的受体γ激动剂,进而抑制一系列与AAA进展相关的生物标志物的产生,包括转化生长因子-β1、骨保护素、骨桥蛋白和基质金属蛋白酶-9。根据这些发现,目前有三种随机对照试验评估非诺贝特和替米沙坦作为限制AAA患者动脉瘤生长的潜在干预措施。 结论:非诺贝特和替米沙坦有可能成为限制AAA生长的新用途药物,目前正在进行进一步评估AAA患者的随机试验。
关键词: 腹主动脉瘤,替米沙坦,非诺贝特,骨桥蛋白,血管紧张素,临床试验。
图形摘要
Current Drug Targets
Title:Fenofibrate and Telmisartan in the Management of Abdominal Aortic Aneurysm
Volume: 19 Issue: 11
关键词: 腹主动脉瘤,替米沙坦,非诺贝特,骨桥蛋白,血管紧张素,临床试验。
摘要: Objective: This mini-review provides the rationale and updated progress for ongoing randomized controlled trials assessing fenofibrate and telmisartan efficacy to limit abdominal aortic aneurysm (AAA) growth.
Methods/Results: There remains an urgent need to identify a drug therapy that will limit AAA growth. Data from preclinical and human studies indicate that fenofibrate and telmisartan have the potential to slow aortic destruction. Fenofibrate has been shown to reduce serum and tissue levels of the proinflammatory protein osteopontin, as well as reducing macrophage recruitment to the aortic wall, both of which are integral processes in the development and progression of AAAs. Telmisartan acts via blockade of the angiotensin II receptor, type 1, and also as a peroxisome proliferator-activated receptor gamma agonist. In turn, this inhibits the production of a range of biomarkers associated with AAA progression, including transforming growth factor-beta one, osteoprotegerin, osteopontin and matrix metalloproteinase- 9. Based on these findings, there are currently three randomized controlled trials assessing both fenofibrate and telmisartan as potential interventions to limit aneurysm growth in AAA patients.
Conclusion: Fenofibrate and telmisartan have potential as repurposed medications to limit AAA growth, and randomized trials for further assessment in AAA patients are ongoing.
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Cite this article as:
Fenofibrate and Telmisartan in the Management of Abdominal Aortic Aneurysm, Current Drug Targets 2018; 19 (11) . https://dx.doi.org/10.2174/1389450119666171227224655
DOI https://dx.doi.org/10.2174/1389450119666171227224655 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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