Future Technologies


Antioxidants

Based on oxidation modification hypothesis rationale, research has begun in implementing antioxidants as a way to treat atherosclerosis. By increasing antioxidants in the body, the number of free radicals should decrease, thereby decreasing the incidents of oxidized low density lipoprotein (OxLDL). In seven studies done in the United States and Europe involving a total of 183,662 of people ranging from 16 years to 105 years, no evidence was shown to indicate vitamin C (ascorbic acid) propagated lower cardiovascular disease and reduced progression of atherosclerosis (Lonn, 2001). However the study was biased to the fact that the majority of patients were suffering from advanced atherosclerosis; the failure of antioxidant vitamins may be due the fact atherosclerosis has progressed too far for antioxidants to make a difference. Another theory for the lack of success with antioxidants may be related to the type of antioxidants being used. Probucol, vitamin C, and butylated hydroxyl toluene are common antioxidants used in these studies that only counter 1e-oxidants. However, if the case of oxidative stress in atherosclerosis was due to 2e-oxidants, different antioxidants would need to be utilized for there to be success (Keaney & Stocker, 2004). This highlights the fact that exact species and sites for the oxidation are very vague. Taking steps toward finding the exact mechanism and species involved for oxidation of LDL by the scientific community would give light to the potential of antioxidant treatment.

Probucol Structure
Probucol Structure

Ascorbic Acid (Vitamin C) Structure
Ascorbic Acid (Vitamin C) Structure

Immunotherapy

The immune system is an important part of the progression of atherosclerosis. One of the major catalysts of this progression is inflammation, which calls the attention of the immune system, specifically T cells. Some scientists have hypothesized that by using antibodies, it is possible to reduce the inflammation at the site of an atherosclerotic lesion and inhibit macrophages into propagating the progression of atherosclerosis. More ideas such as using chemokines (cytokines that help regulate the movement of immune cells around the body) as potential targets to inhibit inflammatory response or targeting the LDL receptor with proprotein convertase subtilisin/kexin type 9 to lower LDL levels have also been proposed. However, even with the potential of these theories, it is clear that the role of inflammation and the immune system must be more clearly defined for scientist to make progress.

Chemokine Structure
Chemokine Structure

Lipid Treatment

In recent studies, scientists have shown that apolipoprotein E (apo-E) keeps arteries soft so they can expand and relax, thus inhibiting atherosclerosis (Blanchard, 2012). The study has also shown that even if there is a high level of cholesterol in the blood, if the arteries are softened to a healthy level, atherosclerosis was repressed. Apo-E could be used with the common statin treatment to increase effectiveness and also reduce the side effects of statins including muscle and joint pain. Apo-E would also be helpful in the treatment of high blood pressure. This protein is part of HDL cholesterol and this discovery could help scientists understand why HDL contributes to better heart health. In the coming future, efforts are being concentrated on developing a drug containing apo-E that could be used to treat humans.

Apolipoprotein E Structure
Apolipoprotein E Structure

References


Blanchard, K. (2012, November 3). Lipid discovery could offer new treatment for heart disease. Retrieved November 4, 2012, from EmaxHealth: http://www.emaxhealth.com/1020/lipid-discovery-could-offer-new-treatment-heart-disease

Highlights from ISA 2012: New focus: targets, treatments and models of care. (2012, March). Retrieved November 1, 2012, from The European Atherosclerosis Society: http://www.eas-society.org/highlights-from-isa-2012.aspx

Keaney, J. J., & Stocker, R. (2004). Role of Oxidation Modifications in Atherosclerosis. Physiological Review vol.84, 1381-1478.

Lonn, E. (2001). Do Antioxidant Vitamins Protect Against Atherosclerosis? Journal of American College of Cardiology, 1795-1798.

New Way of Treating Atherosclerosis - Targeting Innate and Adaptive Immunity. (n.d.). Retrieved November 1, 2012, from European Atherosclerosis Society: http://www2.kenes.com/eas2011/info/Documents/New%20ways%20of%20treating%20atherosclerosis%20-%20targeting%20innate%20and%20adaptive%20immunity.pdf