Therapeutics Targeting Drivers of Thoracic Aortic Aneurysms and Acute Aortic Dissections: Insights from Predisposing Genes and Mouse Models

Dianna M. Milewicz, Siddharth K. Prakash, Francesco Ramirez

Research output: Contribution to journalArticlepeer-review

83 Scopus citations

Abstract

Thoracic aortic diseases, including aneurysms and dissections of the thoracic aorta, are a major cause of morbidity and mortality. Risk factors for thoracic aortic disease include increased hemodynamic forces on the ascending aorta, typically due to poorly controlled hypertension, and heritable genetic variants. The altered genes predisposing to thoracic aortic disease either disrupt smooth muscle cell (SMC) contraction or adherence to an impaired extracellular matrix, or decrease canonical transforming growth factor beta (TGF-β) signaling. Paradoxically, TGF-β hyperactivity has been postulated to be the primary driver for the disease. More recently, it has been proposed that the response of aortic SMCs to the hemodynamic load on a structurally defective aorta is the primary driver of thoracic aortic disease, and that TGF-β overactivity in diseased aortas is a secondary, unproductive response to restore tissue function. The engineering of mouse models of inherited aortopathies has identified potential therapeutic agents to prevent thoracic aortic disease.

Original languageEnglish
Pages (from-to)51-67
Number of pages17
JournalAnnual Review of Medicine
Volume68
DOIs
StatePublished - 14 Jan 2017

Keywords

  • ACTA2
  • Angiotensin receptor
  • Aortopathy
  • Losartan
  • Marfan syndrome
  • Mutation
  • Phenotype
  • TGF-β
  • Thoracic aortic disease

Fingerprint

Dive into the research topics of 'Therapeutics Targeting Drivers of Thoracic Aortic Aneurysms and Acute Aortic Dissections: Insights from Predisposing Genes and Mouse Models'. Together they form a unique fingerprint.

Cite this