Atherosclerosis

Atherosclerosis: Mechanisms, current therapies and the potential of natural products in the prevention and treatment of the disease

Atherosclerosis, a chronic inflammatory disorder of medium and large arteries and the underlying cause of heart attacks and stroke, is responsible for more global deaths than any other disease. A slight reduction in morbidity and mortality from atherosclerosis and its complications has been seen recently, at least in the western world, due to lifestyle changes and pharmaceutical interventions (e.g. statins). However, the global burden from this disease is expected to worsen in the near future because of recent increases in risk factors such as diabetes and obesity. Current pharmaceutical treatments for atherosclerosis are associated with considerable residual risk for cardiovascular disease together with various side effects. With the exception of few successes (e.g. ezetimibe, PCSK9 inhibitors), many pharmaceutical leads against established targets have proved disappointing at the clinical level. It is therefore important that further research is carried out on the molecular basis of atherosclerosis together with alternative therapies for its prevention and treatment.

Natural products have received substantial recent interest in the prevention and treatment of atherosclerosis. However, more research is required that addresses the molecular mechanisms underlying the beneficial effects of natural products together with large clinical trials that evaluate their efficacy. We have recently initiated studies on the effects of many natural products, including certain polyunsaturated fatty acids, polyphenols and probiotics, on several key monocyte/macrophage processes associated with atherosclerosis in vitro and various risk factors in vivo together with the underlying mechanisms. These will be presented in the context of molecular mechanisms underlying atherogenesis together with current therapies and those that are being developed.