PPARgamma and atherosclerosis.
BACKGROUND
Peroxisome proliferator-activated receptor (PPAR)gamma regulates a number of cellular processes that affect glucose homeostasis, endothelial function and vessel wall inflammation, as well as protecting against cardiovascular complications that occur in diabetes. Thiazolidinediones are PPARgamma agonists that are in clinical use for the treatment of type 2 diabetes. Accumulating evidence indicates that thiazolidinediones may exert cardioprotective effects at each stage of atherogenesis.


METHODS
This paper reviews preclinical and clinical evidence (identified from a search of MEDLINE databases) supporting a beneficial cardiovascular effect of thiazolidinediones and discusses the implications of these data for the optimal use of thiazolidinediones in clinical practice.


RESULTS
In vitro animal model and clinical studies indicate that thiazolidinediones correct endothelial dys function, suppress chronic inflammatory processes, reduce fatty streak formation, delay plaque evolution and vessel wall thickening and enhance plaque stabilization and regression.


CONCLUSIONS
Thus, thiazolidinediones show potential as potent anti-inflammatory, antithrombotic agents that could both improve glucose levels and the long-term cardio vascular risk related to atherosclerosis in patients with type 2 diabetes.
Staels
B
B
Département d'Athérosclérose - U.545 Inserm, Institut Pasteur de Lille, et Université de Lille2, Lille, France. bart.staels@pasteur-lille.fr
D000818:Animals; D001161:Arteriosclerosis / Q000188:drug therapy* / Q000503:physiopathology*; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003925:Diabetic Angiopathies; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D023421:Models, Animal; D047495:PPAR gamma / Q000819:agonists / Q000502:physiology*; D045162:Thiazolidinediones / Q000627:therapeutic use*
D002317:Cardiovascular Agents; D005343:Fibrinolytic Agents; D047495:PPAR gamma; D045162:Thiazolidinediones