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Atherosclerosis is a severe cardiovascular disease followed by the accumulation of atherosclerotic plaques within the lumen of blood vessels resulting in reduced blood flow thus initiating a series of events. Conventional therapies for atherosclerosis encounter multiple challenges, especially difficulty in precisely concentrating in certain affected regions and the potential for unwanted side effects. Consequently, scientists are focused on developing nanoformulations for atherosclerosis diagnosis and therapy. Peptide-based nanomedicines improve conventional therapies by offering improved structural and therapeutic stability and enabling target-specific delivery. Their inherent biocompatibility and biodegradability additionally render them desirable materials intended for in vivo use. This review manuscript aims to provide an in-depth overview of peptide-based nanomedicines for atherosclerosis, focusing on targeted cells like endothelial cells, macrophages, and monocytes and their interaction with different plaque components. Moreover, the manuscript also highlights the latest progress in multimodal techniques and provides a comprehensive overview of limitations associated with their practical implementation. [ABSTRACT FROM AUTHOR]

Atherosclerosis is a severe cardiovascular disease followed by the accumulation of atherosclerotic plaques within the lumen of blood vessels resulting in reduced blood flow thus initiating a series of events. Conventional therapies for atherosclerosis encounter multiple challenges, especially difficulty in precisely concentrating in certain affected regions and the potential for unwanted side effects. Consequently, scientists are focused on developing nanoformulations for atherosclerosis diagnosis and therapy. Peptide-based nanomedicines improve conventional therapies by offering improved structural and therapeutic stability and enabling target-specific delivery. Their inherent biocompatibility and biodegradability additionally render them desirable materials intended for in vivo use. This review manuscript aims to provide an in-depth overview of peptide-based nanomedicines for atherosclerosis, focusing on targeted cells like endothelial cells, macrophages, and monocytes and their interaction with different plaque components. Moreover, the manuscript also highlights the latest progress in multimodal techniques and provides a comprehensive overview of limitations associated with their practical implementation.

Change in coronary artery plaque on serial catheter intravascular ultrasound (IVUS) is an established technique to monitor the therapeutic effect of drugs on coronary atherosclerosis. Recent advances in coronary computed tomography angiography (CTA) now allow for non-invasive assessment of change in coronary plaque. Because coronary CTA is noninvasive, it enables clinical trials with lower-risk populations, higher retention rates, and lower costs. This review presents an overview of serial coronary CTA as a noninvasive imaging technique to gauge the therapeutic effect of anti-atherosclerotic therapies. Furthermore, it reviews the increasing use of serial CTA as an imaging endpoint in completed and ongoing clinical trials. [ABSTRACT FROM AUTHOR]

Despite the successful achievements in modern applied medicine and the application of hypolipidemic drugs into clinical practice for the past 50 years, the issue of prevention and treatment of atherosclerotic vascular disease (AVD) remains unsolved. Implementation of the theory of immunopathogenesis of atherosclerosis that was experimentally proved by modern studies allows the specialists to expand the possibilities of pharmacotherapy and pharmacoprevention for AVD. Thus, the aim of the present study was to analyze new directions in the development of anti-atherosclerotic drugs (AAD) with a pathogenetic activity that suppressed chronic autoimmune inflammation in the areas of atherosclerotic damage of vessels. In the course of the study, the search and analysis of the publications in the databases Web of Science, PubMed, and RSCI (Russian Science Citation Index) for the period of 2016-2018 were performed. According to the performed analysis, the most perspective molecular targets for AAD are pro-inflammatory and anti-inflammatory cytokines that develop a disbalance in patients with AVD. Thus, the drugs that are based on monoclonal antibodies to the tumor necrosis factor α (TNFα), and pro-inflammatory interleukins (1β, 17A), used for the treatment of rheumatoid arthritis and psoriasis, can be used for the treatment of AVD. Recombinant interleukins 6, 13, 19, and substances that suppress the expression of interferon regulatory factors will also exert an antiatherogenic effect. The studies on the modeling of the pathogenesis of AVD in inbred animals showed that other molecular targets for AAD could be enzymes involved in the lipid and immune cells metabolism. They include inositolrequiring enzyme 1, proprotein convertase subtilisin/Kexin type 9, and the enzymes of paraoxonase family. Besides, the review includes the discussion of the successful application of drugs based on monoclonal antibodies to TNFα (infliximab), IL-17A (secukinumab) and IL-1β (canakinumab), as well as the drugs with antienzymatic activity (evolocumab and darapladib), in clinical practice for the treatment of AVD. The modern knowledge on molecular mechanisms of immunopathogenesis can give grounds for the development of drugs for pathogenetic pharmacotherapy and pharmacoprevention for the complications of AVD. The most effective solution would be the indication of drugs that affect the disbalance of cytokines and metabolic processes in the immune cells. [ABSTRACT FROM AUTHOR]