Researchers have developed a new therapy based on nanoparticles to rid the arteries of dangerous deposits that can accumulate there, giving rise to serious health problems. An innovation that could bring considerable added value in terms of public health.
More specifically, the authors of this work work on theatherosclerosis. It is a disease characterized by the accumulation of plaque on the inner wall of the arteries. These deposits increase the thickness and stiffness of the vessels, thereby reducing the amount of blood that can flow through them. In severe cases, this can lead to near-total blockage that requires surgery, such as stenting.
In some cases, this plaque can also be inflammatory. This is an even more concerning situation, because the plaque can then rupture and obstruct other parts of the circulatory system without warning — with potentially catastrophic consequences for the patient.
« Although these plaques may not block the entire artery, their rupture can completely block blood flow suddenly, resulting in a heart attack that can seem to come out of nowhere. », Explains Bryan Smith, co-author of the study. “ This is the scariest scenario, the one that leads to the majority of heart attacks ».
No ideal treatment yet
There are many ways to limit the accumulation of this plaque, which is essentially made up of lipids such as cholesterol and dead cell debris. The most obvious is to adopt a healthy lifestyle (balanced diet, regular exercise, etc.). But once it is installed, taking care of it is much more difficult. Most of the time, we have to settle for treatments based on substances such as statins, which inhibit the synthesis of “bad” cholesterol to slow down the accumulation of plaque as much as possible. In the most serious cases, procedures such as atherectomy or angioplasty take over. A solution that is anything but ideal, as these surgical approaches always present a certain risk.
In summary, at present, there is no no highly effective, non-invasive treatment that can physically rid the arteries of these disruptive elements.
Nanoparticles to the rescue
But that could soon change thanks to this new study. To combat plaque, Smith and his team used a mechanism already present in our body. When a cell is too old or damaged, it usually triggers apoptosis — a type of controlled cellular suicide that helps maintain a healthy cell population. The remains are then removed by phagocytesa family of cells that can be likened to biological garbage collectors, in a process called efferocytosis.
This dynamic plays a crucial role in the maintenance of the arteries. By eliminating these cellular wastes, phagocytes also limit the accumulation of plaque. Smith and his colleagues therefore sought to enhance efferocytosis using a substance designed to stimulate phagocytes called macrophages.
They then introduced this substance into the bloodstream via nanoparticlestiny objects capable of infiltrating biological tissues. In practice, these nanoparticles behave both as Trojan horses and recruiters that encourage macrophages to attack plaque very aggressively.
Excellent results without surgery or side effects
And the results of the first tests, carried out on mice and pigs, were extremely encouraging. To begin with, the team found that the animals’ arteries had significantly less plaque at the end of the treatment. This suggests that the macrophages have done their job; by destroying the cellular debris which contributes to the coherence of the plaque, they allowed the latter to disintegrate into small elements, without risk of obstruction. Additionally, the level of inflammation was significantly reduced, reducing the risk of rupture of the remaining plaque — and by extension, a heart attack.
They then sought to verify whether this treatment had produced unwanted side effects. There is indeed a risk that these supercharged phagocytes will begin to attack red blood cells, leading to very problematic anemia. Fortunately, the fact that it was a targeted therapy avoided this collateral damage, and the researchers observed no harmful consequences.
Building on this great success, the team is now focused on its next objective: preparing a clinical trial to bring this treatment to humans. The process will undoubtedly take several years, but it will be worth it; Cardiovascular diseases are a major mortality factor in many countries, and being able to clean the arteries from the inside without having to undergo surgery could therefore make a real difference in terms of public health.
The text of the study is available here.
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