The cardiovascular system is an extremely dynamic environment, and its performance heavily relies on the synergies of its main players. The heart, arteries, and veins all must work together to provide the rest of the body with blood flow supplying sufficient oxygen and nutrients. Cardiovascular diseases (CVDs) emerge when one or more of these players become affected, and the effects are often dramatic: CVDs are the leading cause of death globally, representing over 30% of deaths. Every 90 seconds, someone is dying of heart disease. Heart conditions remain the biggest challenge for the healthcare sector, and that is just the beginning… Direct and indirect costs of cardiovascular diseases and stroke total exceed $320.1 billion US dollars.
The heart, the one muscle responsible for keeping us alive, is causing more deaths
than anything else on the planet.
Heart disease is an umbrella term for an extremely broad group of diseases. Some are inherited, but most are caused by unhealthy lifestyle. One example is atherosclerosis, a condition characterized by thickening or hardening of the arteries, is a very commonly observed CVD. In severe cases, it can cause coronary artery disease and myocardial infarction. While many physiological changes are observed in this condition, including narrowing of the arterial lumen due to growing plaques (see image) and increased inflammation, one common feature is stiffening of the arterial wall due to calcification. In healthy arteries, elastic fibres found in the vessel wall provide elasticity, which allows deformation under the hemodynamic load applied at every heartbeat. These elastic fibres are called elastin and prevent energy dissipation and permanent vessel deformation. When this elasticity is lost, much more energy is lost per beat and the heart needs to work harder to match this loss, often leading to hypertension.
In atherosclerotic lesions, degradation of elastin is observed and is associated with increased arterial wall stiffness and calcification. Reducing this calcification and restoring the damaged elastin fibers could be a key element in reversing the effects of atherosclerosis, thereby reducing the risk of future cardiac events.
Atherosclerosis is in most cases easily preventable and mostly reversible - if not too progressed - condition just by making consistently healthier lifestyle choices. We could be just a heartbeat away (pun intended) from significantly reducing the burden of cardiovascular diseases if we just put our mind to it. However, not all cardiovascular diseases, or even diseases in general, have this luxury. Once present, CVDs are often difficult to treat; therapies for CVDs able to not just manage, but fully reverse the observed damage are drastically required. Several innovative new approaches target elastin, by removing the harmful calcification and restoring the damaged elastin. By specifically targeting damaged elastin fibres and delivering drugs to the affected sites, these approaches could first reverse the vessel calcification, and subsequently restore the damaged elastin fibres.
CVDs are not the only disease category where the elastin protein is directly implicated; there are in fact many more… Stay tuned to find out more about this crucial tissue!
Cocciolone, A.J., Hawes, J.Z., Staiculescu, M.C., Johnson, E.O., Murshed, M. and Wagenseil, J.E., 2018. Elastin, arterial mechanics, and cardiovascular disease. American Journal of Physiology-Heart and Circulatory Physiology, 315(2), pp.H189-H205.
Mithieux, S.M. and Weiss, A.S., 2005. Elastin. Advances in protein chemistry, 70, pp.437-461.