Arteriosclerosis treatment
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Advances in Arteriosclerosis Treatment: A Comprehensive Overview
Autologous Adipose-Derived Mesenchymal Stem Cells (Ad-MSC)
Recent studies have highlighted the potential of autologous adipose-derived mesenchymal stem cells (Ad-MSC) in treating arteriosclerosis. Clinical data indicate that Ad-MSC administration significantly improves lipid profiles, including HDL, LDL, and remnant-like particle cholesterol levels, without adverse effects. Patients with abnormal HDL values before treatment showed marked improvement post-treatment. Additionally, significant decreases in intimal-media thickness (IMT) and cardio-ankle vascular index (CAVI) were observed, suggesting that Ad-MSC therapy is both safe and effective for arteriosclerosis management.
Platelet Inhibition and Carotid Arteriosclerosis
For carotid arteriosclerosis, managing controllable risk factors such as hypertension, smoking, and elevated blood lipids is crucial. Platelet inhibitors, particularly aspirin and ticlopidine, are recommended for symptomatic carotid disease. Carotid endarterectomy is beneficial for patients with significant stenosis (≥70%), but its efficacy for lower levels of stenosis remains uncertain. Additionally, clopidogrel has been shown to reduce transplant arteriosclerosis, indicating its potential in managing arteriosclerosis through platelet inhibition.
Hormonal Therapy: Estradiol
Estradiol treatment has demonstrated efficacy in preventing transplant arteriosclerosis in experimental models. In rabbits, estradiol administration abolished MHC class II antigen expression and reduced macrophage and T-lymphocyte infiltration in coronary arteries. This was associated with a significant decrease in myointimal thickening, suggesting that estradiol may inhibit arteriosclerosis through immune modulation.
Peripheral Blood Stem Cells (PBSC)
Autologous transplantation of mobilized peripheral blood stem cells (PBSC) has shown promise in treating severe arteriosclerosis obliterans of the lower extremities. Patients receiving PBSC therapy exhibited significant improvements in clinical symptoms, such as pain and ulceration, and enhanced blood flow metrics. This approach appears to be a practical, safe, and effective treatment for lower limb ischemia.
ACE Inhibitors
Angiotensin-converting enzyme (ACE) inhibitors have been effective in regressing arteriosclerotic changes induced by chronic nitric oxide synthesis inhibition. In rat models, ACE inhibitors like imidapril reduced coronary artery arteriosclerosis by inducing apoptosis in inflammatory cells. This suggests that ACE inhibitors can mitigate arteriosclerosis by targeting inflammatory pathways.
Diet and Lipotropic Agents
Dietary interventions and lipotropic agents have been explored as treatments for arteriosclerosis. Low cholesterol diets aim to reduce lipid deposition in arterial walls, while lipotropic agents facilitate lipid mobilization and removal. Although these approaches are based on the hypothesis that arteriosclerosis is a lipid metabolism disorder, their clinical efficacy requires further validation.
Conclusion
The treatment landscape for arteriosclerosis is evolving, with promising therapies ranging from stem cell administration and platelet inhibition to hormonal and dietary interventions. Each approach targets different aspects of the disease, offering a multifaceted strategy for managing and potentially reversing arteriosclerosis. Continued research and clinical trials will be essential to fully establish the efficacy and safety of these treatments.
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