Novel Therapeutical Approaches to Managing Atherosclerotic Risk

• Type of Material: Article
• Authors: Rosaria V Giglio, University of Palermo; Anca Pantea Stoian, Carol Davila Univ; Khalid Al-Rasadi, Sultan Qaboos University; Maciej Banach, Medical University Lodz; Angelo M Patti, University of Palermo; Marcello Ciaccio, University of Palermo; Ali A Rizvi, Emory University; Manfredi Rizzo, Carol Davila Univ
• Language: English
• Date: 2021-05-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the authors.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/ijms22094633
• Title of Journal or Parent Work: INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
• Volume: 22
• Issue: 9
• Grant/Funding Information: This research received no external funding.
• Keywords: nutraceuticals; SMOOTH-MUSCLE-CELLS; Biochemistry & Molecular Biology; GENE-EXPRESSION; METABOLIC SYNDROME; Chemistry; ATHEROGENIC DYSLIPIDEMIA; innovative therapies; inflammations; PLASMA LIPOPROTEIN(A) CONCENTRATIONS; LIPID-METABOLISM; DEPENDENT INSULINOTROPIC POLYPEPTIDE; GASTRIC-INHIBITORY POLYPEPTIDE; management; ENDOTHELIAL DYSFUNCTION; Physical Sciences; Life Sciences & Biomedicine; Science & Technology; oxidative stress; atherosclerosis; molecular signaling; Chemistry, Multidisciplinary; CEREBROVASCULAR EVENTS
• Research Categories: Health Sciences, Nutrition

Abstract

Atherosclerosis is a multifactorial vascular disease that leads to inflammation and stiff-ening of the arteries and decreases their elasticity due to the accumulation of calcium, small dense Low Density Lipoproteins (sdLDL), inflammatory cells, and fibrotic material. A review of studies pertaining to cardiometabolic risk factors, lipids alterations, hypolipidemic agents, nutraceuticals, hypoglycaemic drugs, atherosclerosis, endothelial dysfunction, and inflammation was performed. There are several therapeutic strategies including Proprotein Convertase Subtilisin/Kexin 9 (PCSK9) inhibitors, inclisiran, bempedoic acid, Glucagon-Like Peptide-1 Receptor agonists (GLP-1 RAs), and nutraceuticals that promise improvement in the atheromatous plaque from a molecular point of view, because have actions on the exposure of the LDL-Receptor (LDL-R), on endothelial dysfunction, activation of macrophages, on lipid oxidation, formations on foam cells, and deposition extracellular lipids. Atheroma plaque reduction both as a result of LDL-Cholesterol (LDL-C) intensive lowering and reducing inflammation and other residual risk factors is an integral part of the management of atherosclerotic disease, and the use of valid therapeutic alternatives appear to be appealing avenues to solving the problem.