Novel therapies targeting vascular endothelium

Endothelial dysfunction has been identified as a major mechanism involved in all the stages of atherogenesis. Evaluation of endothelial function seems to have a predictive role in humans, and therapeutic interventions improving nitric oxide bioavailability in the vasculature, may improve the long-term outcome in healthy individuals, high-risk subjects or patients with advanced atherosclerosis. Several therapeutic strategies are now available, targeting both the synthesis and oxidative inactivation of NO in human vasculature. Statins seem to be currently the most powerful category of these agents, improving endothelial function and decreasing cardiovascular risk after long-term administration. Other cardiovascular agents improving endothelial function in humans are angiotensin converting enzyme inhibitors/angiotensin receptors blockers, which increase NO bioavailability by modifying rennin-angiotensin-aldosterone system. Newer therapeutic approaches targeting endothelial dysfunction in specific disease states include insulin sensitizers, novel antioxidant compounds or combinations of classic antioxidant agents as well as substances which target endothelial nitric oxide synthase 'coupling'. In the future genetic profile may help to identify potential responders to treatments targeting specific intracellular pathways in vascular endothelium. ©2011 Nova Science Publishers, Inc. All rights reserved.