Targeting Dangerous Inflammation Inside Artery Plaque

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New Mount Sinai Study Shows Nanomedicine Therapy Reduces Heart Attack Risk by Halting Artery Plaque Growth and Suppressing Inflammation

A research team showed that a nanotherapeutic medicine can halt the growth of artery plaque cells resulting in the fast reduction of the inflammation that may cause a heart attack, according to a study led by researchers from Icahn School of Medicine at Mount Sinai and published April 3 in Science Advances.

“In just one week our novel cell proliferation-specific approach successfully suppressed atherosclerotic plaque growth and inflammation in mice engineered to mimic human vascular disease,” says lead study author Jun Tang, MS, a PhD student at Icahn School of Medicine at Mount Sinai. “Atherosclerosis is a major cause of death around the globe, and our nanomedicine strategy promises to offer a new way to reduce the number of heart attacks and strokes.”

Building upon a recent discovery by their Massachusetts General Hospital research collaborators that macrophage proliferation dictates atherosclerosis-related vessel wall inflammation, the Mount Sinai research team applied a nanomedicine strategy with a molecule of “good cholesterol,” or high-density lipoprotein (HDL), a naturally occurring shuttle that travels from the liver to arteries. The research team took advantage of HDL’s natural travel routes, loading it with the widely-used cholesterol-lowering medication called simvastatin (Zocor), which it shuttles into arterial walls.

The simvastatin-loaded nanoparticles, named S-HDL, work by targeting inflamed immune cells called macrophages within high-risk arterial plaques. These macrophages become laden with cholesterol and start proliferating in plaques, thereby increasing inflammation. This lipid-driven inflammatory process drives atherosclerotic plaque buildup and rupture leading to a heart attack or stroke.

Since patients hospitalized after heart attack or stroke have a high recurrence rate of up to 20 percent within three years, the researchers also tested the possible benefits of adding an eight-week regimen of oral statins after the one-week S-HDL nanotherapy. Mice study results showed superior long-term therapeutic benefits of a combined total nine-week S-HDL and oral statins regimen, by first rapidly reducing plaque inflammation and then continuously keeping it suppressed.

“We envision our S-HDL nanomedicine therapy could be translated quickly to human clinical trials as a short-term infusion therapy for heart attack and stroke patients to rapidly suppress plaque inflammation, which can be sustained using current standard of care oral statin medication,” says Zahi Fayad, PhD, Professor of Radiology and Director of the Translational and Molecular Imaging Institute at Icahn School of Medicine at Mount Sinai.

“Nanotherapeutically inhibiting local macrophage proliferation is possible and we can effectively apply it to treat inflammation inside arteries. Collectively, our results demonstrate that the two-step regimen not only reduces macrophage accumulation but also reduces the expression of key genes linked to inflammation in this cell type,” says senior study author Willem Mulder, PhD, Associate Professor of Radiology in the Translational and Molecular Imaging Institute at the Icahn School of Medicine at Mount Sinai.

Researchers look forward to translating their promising mice study findings to larger animal models and human clinical trials in the near future.

This study was funded by the NHLBI, NIH Program of Excellence in Nanotechnology (PEN) Award (HHSN368201000045C, to Z.A.F); NIH grants R01 HL118440 (W.J.M.M.), R01 HL125703 (W.J.M.M.), R01 CA155432 (W.J.M.M.), R01 EB009638 (Z.A.F.); Harold S. Geneen Charitable Trust Award (Z.A.F.); and American Heart Association Founders Affiliate Predoctoral Award (13PRE14350020-Founders, to J.T.)

About the Mount Sinai Health System
The Mount Sinai Health System is an integrated health system committed to providing distinguished care, conducting transformative research, and advancing biomedical education. Structured around seven hospital campuses and a single medical school, the Health System has an extensive ambulatory network and a range of inpatient and outpatient services—from community‐based facilities to tertiary and quaternary care.

The System includes approximately 6,600 primary and specialty care physicians, 12‐minority‐owned free‐standing ambulatory surgery centers, over 45 ambulatory practices throughout the five boroughs of New York City, Westchester, and Long Island, as well as 31 affiliated community health centers. Physicians are affiliated with the Icahn School of Medicine at Mount Sinai, which is ranked among the top 20 medical schools both in National Institutes of Health funding and by U.S. News & World Report.

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Lauren Woods
The Mount Sinai Hospital
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