Drugs Targeting Epigenetic Histone Acetylation in Vascular Smooth Muscle Cells for Restenosis and Atherosclerosis

Abstract

It is well known that atherosclerosis and restenosis are common cardiovascular diseases and major health care problems. Vascular remodeling and migration and proliferation of vascular smooth muscle cells (VSMCs) are key features of these pathologies. There has been enormous progress in drug development and clinical management of these disorders, with angioplasty and drug eluting stents being standard procedures to treat vascular obstruction. However, despite their benefits, these current treatment modalities are not always efficacious. Furthermore, they can also be associated with postoperative complications and graft failures, some of which can be life threatening. Evaluation of newer mechanisms involved in VSMC proliferation aimed at uncovering additional therapeutic approaches to curb VSMC dysfunction in cardiovascular diseases is clearly warranted. See accompanying article on page 851 Accumulating evidence suggests that several common diseases, including cardiovascular disorders, diabetes, and the vascular complications of diabetes, are governed by a combination of genetic and environmental factors and that epigenetic mechanisms, such as DNA methylation and histone modifications in chromatin, form a key link between them.1–3 Epigenetics is the added layer of gene regulation that occurs in chromatin without changes in the actual underlying DNA sequence and plays a major role in dictating cell-specific gene expression patterns and transcriptional outcomes.4,5 Along with DNA methylation, key posttranslational modifications of histone N-terminal tails can alter chromatin structure to form an added layer of gene regulation and modulate gene transcription.5 Therefore, gene transcription depends on chromatin structure, which is very dynamic, depending on a multitude of histone posttranslational modifications that allow for the conversion of inaccessible, compact, or …