Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes
Atherosclerosis of the coronary arteries continues to be one of the major global health burdens and acute coronary syndrome is responsible annually for at least 30 % of all deaths globally. Acute coronary syndrome may be the consequence of thrombus formation after erosion or rupture of obstructive o...
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Elsevier
2025-03-01
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| Series: | Pharmacological Research |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S104366182500060X |
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| author | Loredana Bucciarelli Daniele Andreini Giulio Stefanini Roberta Maria Fiorina Marco Francone Federica Catapano Maria Elena Lunati Edoardo Conte Davide Marchetti Paolo Fiorina |
| author_facet | Loredana Bucciarelli Daniele Andreini Giulio Stefanini Roberta Maria Fiorina Marco Francone Federica Catapano Maria Elena Lunati Edoardo Conte Davide Marchetti Paolo Fiorina |
| author_sort | Loredana Bucciarelli |
| collection | DOAJ |
| description | Atherosclerosis of the coronary arteries continues to be one of the major global health burdens and acute coronary syndrome is responsible annually for at least 30 % of all deaths globally. Acute coronary syndrome may be the consequence of thrombus formation after erosion or rupture of obstructive or non-obstructive atherosclerotic plaque. The rupture of plaques is mostly caused by mechanical stress usually called cap fatigue. Vulnerable plaques are characterized by a softer atheromatous core and a thinner fibrous cap, with inflammation and hypercholesterolemia playing a crucial role in the atherothrombotic process. Based on animal studies that extend back to the 1920s, regression of atherosclerotic plaques in humans has just started to be considered and pursued. The idea that the human atherosclerotic plaques could regress at all met an important resistance over the decades; indeed, advanced plaques contain components, such as necrosis, calcification and fibrosis, which are hard to be removed. However, new animal models and imaging technics allowed a more complete and accurate quantitative assessment of plaque volume and are shedding new light on atherosclerosis regression. In this review, we are revisiting the existence of atherosclerosis regression in preclinical and clinical studies, with a focus on the latest mechanistic insights and on the newest pharmacological agents, particularly in patients with diabetes. Interestingly, we suggested that based on literature insights and preclinical studies, a combination of drugs to target hyperglycemia, dyslipidemia and inflammation may be desirable for a fast-track Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes. |
| format | Article |
| id | doaj-art-9ced008d29214a6395556a0600b84fe4 |
| institution | Kabale University |
| issn | 1096-1186 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pharmacological Research |
| spelling | doaj-art-9ced008d29214a6395556a0600b84fe42025-02-09T04:59:44ZengElsevierPharmacological Research1096-11862025-03-01213107635Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetesLoredana Bucciarelli0Daniele Andreini1Giulio Stefanini2Roberta Maria Fiorina3Marco Francone4Federica Catapano5Maria Elena Lunati6Edoardo Conte7Davide Marchetti8Paolo Fiorina9Pio Albergo Trivulzio, Italy; International Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di scienze Biomediche e Cliniche, Università di Milano, ItalyDivision of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Humanitas Research Hospital IRCCS, Rozzano, Milan, ItalyInternational Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di scienze Biomediche e Cliniche, Università di Milano, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Humanitas Research Hospital IRCCS, Rozzano, Milan, ItalyDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Humanitas Research Hospital IRCCS, Rozzano, Milan, ItalyDivision of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, ItalyDivision of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, ItalyDivision of University Cardiology, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, ItalyInternational Center for T1D, Pediatric Clinical Research Center Romeo ed Enrica Invernizzi, Dipartimento di scienze Biomediche e Cliniche, Università di Milano, Italy; Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy; Nephrology Division, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA; Correspondence to: Nephrology Division, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave. Enders Building, Boston, MA 02115, USA.Atherosclerosis of the coronary arteries continues to be one of the major global health burdens and acute coronary syndrome is responsible annually for at least 30 % of all deaths globally. Acute coronary syndrome may be the consequence of thrombus formation after erosion or rupture of obstructive or non-obstructive atherosclerotic plaque. The rupture of plaques is mostly caused by mechanical stress usually called cap fatigue. Vulnerable plaques are characterized by a softer atheromatous core and a thinner fibrous cap, with inflammation and hypercholesterolemia playing a crucial role in the atherothrombotic process. Based on animal studies that extend back to the 1920s, regression of atherosclerotic plaques in humans has just started to be considered and pursued. The idea that the human atherosclerotic plaques could regress at all met an important resistance over the decades; indeed, advanced plaques contain components, such as necrosis, calcification and fibrosis, which are hard to be removed. However, new animal models and imaging technics allowed a more complete and accurate quantitative assessment of plaque volume and are shedding new light on atherosclerosis regression. In this review, we are revisiting the existence of atherosclerosis regression in preclinical and clinical studies, with a focus on the latest mechanistic insights and on the newest pharmacological agents, particularly in patients with diabetes. Interestingly, we suggested that based on literature insights and preclinical studies, a combination of drugs to target hyperglycemia, dyslipidemia and inflammation may be desirable for a fast-track Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes.http://www.sciencedirect.com/science/article/pii/S104366182500060XAtherosclerosisRegression plaqueInflammationAnti-dislipidemic therapy |
| spellingShingle | Loredana Bucciarelli Daniele Andreini Giulio Stefanini Roberta Maria Fiorina Marco Francone Federica Catapano Maria Elena Lunati Edoardo Conte Davide Marchetti Paolo Fiorina Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes Pharmacological Research Atherosclerosis Regression plaque Inflammation Anti-dislipidemic therapy |
| title | Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes |
| title_full | Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes |
| title_fullStr | Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes |
| title_full_unstemmed | Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes |
| title_short | Pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes |
| title_sort | pharmacological regression of atherosclerotic plaque in patients with type 2 diabetes |
| topic | Atherosclerosis Regression plaque Inflammation Anti-dislipidemic therapy |
| url | http://www.sciencedirect.com/science/article/pii/S104366182500060X |
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