Aneurismi aortici addominali (AAA) sono una causa principale di morte.
Attualmente, il trattamento per AAA è la riparazione chirurgica e non ci sono terapie mediche approvate dalla FDA per AAA. Molte ricerche sono in corso per scoprire nuove terapie mediche per AAA. La fisiopatologia di AAA è intesa come un complesso gioco di processi infiammatori e proteolitici che degenerano la parete aneurisma. La calcificazione arteriosa, osservata in AAA ma in misura minore rispetto alla malattia occlusiva arteriosa, si verifica in maniera simile alla deposizione minerale nell'osso. Le cellule come gli osteoblasti sono responsabili della deposizione minerale nelle placche aterosclerotiche. Recentemente, cellule simili a osteoclasti - la controparte catabolica degli osteoblasti - sono state scoperte in placche aterosclerotiche. Inoltre, cellule simili a osteoclasti sono presenti nella parete di AAA, ma non in aorte sane.
Le cellule simili a osteoclasto secernono le metalloproteinasi della matrice (MMP) - proteasi implicate nella degenerazione della parete aneurisma arteriosa - e possono contribuire alla degradazione della parete aneurisma. L'inibizione di cellule simili a osteoclasti può impedire la progressione dell'anestesia riducendo i livelli tissutali di MMP.
In questa recensione, discutiamo la fisiopatologia della formazione AAA e il ruolo attuale della terapia medica nel trattamento di AAA. Inoltre, evidenziamo l'ipotesi emergente che gli osteoclasti svolgono un ruolo chiave nello sviluppo di AAA e si cercano terapie per inibire l'osteoclastogenesi in AAA.
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