Abstract

Natural Products in the Prevention and Treatment of Atherosclerosis

Dipak Ramji, Professor, Cardiff University

Atherosclerosis, an inflammatory disorder of the vasculature and the underlying cause of myocardial infarction and stroke, is responsible for more deaths worldwide than any other disease. A marginal decrease in morbidity and mortality from atherosclerosis and its complications has been seen recently, at least in the western world, due to pharmaceutical intervention (e.g. statins) and lifestyle changes. 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, obesity and hypertension. Current pharmaceutical treatments for atherosclerosis are associated with considerable residual risk for cardiovascular disease together with various side effects. Apart from 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 performed on alternative therapies for the prevention and treatment of atherosclerosis. Natural products have received substantial recent interest in the prevention and treatment of atherosclerosis (see our article last year in Nature Reviews Cardiology 13:513-32). 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 (e.g. monocytic migration, foam cell formation, phagocytosis, production of reaction oxygen species and activation of the inflammatory response) and various risk factors in vivo together with the underlying mechanisms. These will be presented in the context of current therapies and those that are being developed.