Research | A Breakthrough in Peripheral Arterial Disease

Research | A Breakthrough in Peripheral Arterial Disease
Brian H. Annex, MD, Cardiovascular Medicine

A discovery by Division of Cardiovascular Medicine chief Brian Annex and his colleagues is opening up new avenues for treating peripheral arterial disease (PAD), a common circulation problem that afflicts millions of Americans. Researchers have pinpointed a key genetic regulator that appears to controls the ability to adapt to blockages in blood vessels – and it turns out to be a tiny RNA molecule.

The finding gives researchers a new target for potential therapies to treat patients with peripheral arterial disease, as well as allowing them to better understand the progression of the disease in patients.

“Why does one person with peripheral arterial disease remain stable and do well while another person has a much worse clinical course? We need to begin to unravel these types of questions,” said Dr. Annex. “When we see a patient with peripheral arterial disease, the reality is that information we get out of their age, gender, risk factors and basic clinical measures doesn’t tell us how the patient is going to do. We’re often left with uncertainty. I think as we begin to understand the [implications of the discovery] we will better understand PAD and open up entirely new treatment approaches.”

The discovery presents an exciting new possibility for treating PAD by boosting the effects of microRNA-93, Annex said. “To date, drugs used to treat patients with PAD have always tried to target a single gene, whereas it’s very clear this microRNA has significant effects on multiple related genes,” he said. “This opens up an entirely new paradigm for treating and understanding peripheral arterial disease.”

While more research needs to be done, Annex foresees several potential ways doctors could manipulate microRNA-93 to target PAD and avoid problems that plague other efforts to develop new treatments.

The new findings were discussed in a paper published in the journal Circulation.

Hazarika S, Farber CR, Dokun AO, Pitsillides AN, Wang T, Lye RJ, Annex BH. MicroRNA-93 controls perfusion recovery after hindlimb ischemia by modulating expression of multiple genes in the cell cycle pathway. Circulation. 2013 Apr 30;127(17):1818-28.