China
Africa
Explore chapters and articles related to this topic
Nanoengineering Neural Cells for Regenerative Medicine
Published in Klaus D. Sattler, st Century Nanoscience – A Handbook, 2020
Christopher F. Adams, Stuart I. Jenkins
Transplanted NSCs (a key clinical neural transplant population) engineered to release NT-3 and GDNF have shown enhanced neurite extension of host axons into lesion sites and greater evidence of neurogenesis from the transplanted NSCs when compared to non-engineered controls (Lu et al., 2003; Park et al., 2006; Kameda et al., 2007). In a similar manner, NSC-mediated delivery of molecules which target underlying disease pathologies have also been developed. For example, NSCs can increase synaptic connectivity and neuronal survival and consequently cognitive function in a rat model with Alzheimer’s. Subsequent engineering of the NSCs to release neprilysin was shown to further address the underlying pathology of Alzheimer’s disease by breaking down amyloid plaques in diseased areas (Blurton-Jones et al., 2014). These studies demonstrate the great potential in combining neuroprotective efficacy of NSCs with biomolecule delivery to address several therapeutic goals in one step (also see Section 17.1.3).
The role of transcatheter mitral valve leaflet approximation for the treatment of secondary mitral regurgitation: current status and future prospects
Published in Expert Review of Medical Devices, 2021
Noé Corpataux, Nicolas Brugger, Lukas Hunziker, David Reineke, Stephan Windecker, Alec Vahanian, Fabien Praz
Although only few studies have specifically investigated SMR changes under medical treatment, the initiation or optimization of GDMT is the mainstay of treatment in patients with HF and SMR [5,34]. Beta-blockers, angiotensin converting enzyme inhibitors, angiotensin receptor blocker inhibitors and mineralocorticoid receptor antagonists primarily target the underlying LV dysfunction and should be titrated to the maximally tolerated dose. These neurohormonal inhibitors reduce the risk of HF-related hospitalization and mortality by improving LV dysfunction and promoting reverse remodeling [35–37]. A recent study of 163 consecutive patients with HF (left ventricular ejection fraction [LVEF] <40%) and grade 3–4+ SMR despite GDMT showed a sustained reduction to non-severe SMR in 38% of the patients, while 18% had SMR progression to grade 3+ [38]. Since 2017, sacubitril/valsartan, a combination of the angiotensin receptor blocker valsartan with the neprilysin inhibitor sacubitril has been approved as an alternative to angiotensin receptor blocker inhibitors after showing superiority to enalapril in reducing the risk of death and HF hospitalization in HF patients [39]. The PRIME study investigated this new drug against valsartan in addition to GDMT regarding SMR reduction. The primary outcome consisting of effective regurgitant orifice area change at 12 months was assessed in 118 patients. SMR reduction was significantly higher in the sacubitril/valsartan group (−0.058 cm2 vs. −0.018 cm2; p = 0.032) (Figure 2) [40]. Of note, the SMR population investigated in this study had a much lower 1-year mortality rate (0.8%) compared to the patients included in the TMVr randomized trials, so that both populations may not be easily comparable.