Decoy Technology as a Promising Therapeutic Tool for Atherosclerosis

Abstract

Cardiovascular diseases (CVDs) have been classified into several types of disease, of which atherosclerosis is the most prevalent. Atherosclerosis is characterized as an inflammatory chronic disease which is caused by the formation of lesions in the arterial wall. Subsequently, lesion progression and disruption ultimately lead to heart disease and stroke. The development of atherosclerosis is the underlying cause of approximately 50% of all deaths in westernized societies. Countless studies have aimed to improve therapeutic approaches for atherosclerosis treatment; however, it remains high on the global list of challenges toward healthy and long lives. Some patients with familial hypercholesterolemia could not get intended LDL-C goals even with high doses of traditional therapies such as statins, with many of them being unable to tolerate statins because of the harsh side effects. Furthermore, even in patients achieving target LDL-C levels, the residual risk of traditional therapies is still significant thus highlighting the necessity of ongoing research for more effective therapeutic approaches with minimal side effects. Decoy-based drug candidates represent an opportunity to inhibit regulatory pathways that promote atherosclerosis. In this review, the potential roles of decoys in the treatment of atherosclerosis were described based on the in vitro and in vivo findings.

Early growth response-1: Key mediators of cell death and novel targets for cardiovascular disease therapy

“…Their findings showed that these NF- κ B decoy ODNs exhibited a safe and beneficial effect on preventing restenosis after percutaneous coronary treatment since they prevented the apoptosis of ECs under hypoxia ( 121 ). To summarize, the use of EGR1 decoy ODNs as a novel therapy tool is critical for the prevention and treatment of coronary heart disease and restenosis after angioplasty ( 123 , 124 ) ( Figure 3 ).…”

Molecular Mechanisms Underlying Pathological and Therapeutic Roles of Pericytes in Atherosclerosis

“…The treatment of AS was addressed in countless studies; despite the constant development of new therapeutic strategies and drugs (such as nanomedicine, decoy and anti-platelet drug-loaded targeted technologies) [ 98 , 99 , 100 ], lipid-lowering and anti-inflammatory drugs are currently used as the principal drug in the first- and second-line treatments to prevent coronary artery disease [ 101 , 102 ]. However, pericytes may suggest some new diagnoses and therapeutic strategies for AS and other vascular pathologies [ 13 ].…”

In silico and in vitro analysis of microRNAs with therapeutic potential in atherosclerosis

“…Despite advances in developing novel therapies 4 – 10 , cardiovascular diseases, mainly atherosclerosis, are still the leading causes of death in the world, and these have been predicted to increase in the coming decades 3 . To circumvent the limitations of conventional therapies, there is an obvious need to provide multi-pronged therapeutic approaches that largely focus on the risk factors involved in these diseases 11 – 13 . Recently, nucleic acid-based therapies have been considerably developed and have revealed promising potential as a therapeutic platform in the treatment of a variety of diseases, some of which have been approved by the US Food and Drug Administration (FDA) 13 , 14 .…”

“…To circumvent the limitations of conventional therapies, there is an obvious need to provide multi-pronged therapeutic approaches that largely focus on the risk factors involved in these diseases 11 – 13 . Recently, nucleic acid-based therapies have been considerably developed and have revealed promising potential as a therapeutic platform in the treatment of a variety of diseases, some of which have been approved by the US Food and Drug Administration (FDA) 13 , 14 . Clinical trial-based studies have demonstrated the efficacy of these therapeutics in the treatment of atherosclerosis.…”

“…Clinical trial-based studies have demonstrated the efficacy of these therapeutics in the treatment of atherosclerosis. Among them, RNA-based therapeutics, specifically small interfering RNAs (siRNAs) and antisense oligonucleotides (ASO) to miRNAs, exhibit great potential as therapeutic candidates in the treatment of diseases such as atherosclerosis 13 , 15 .…”