Document Detail


Marfan syndrome, magnesium status and medical prevention of cardiovascular complications by hemodynamic treatments and antisense gene therapy.
MedLine Citation:
PMID:  12735484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The medical management of Marfan Syndrome (MFS) mainly relies on early prevention of the aortic complications. Hemodynamic treatments try to diminish the forcefulness of cardiac contractions and to reduce blood pressure: for example long term administration of propranolol may significantly reduce the rate of increase in aortic ratio (aortic diameter/expected aortic diameter). Retardation of aortic dilatation may be most often observed by early treatment started when the baseline end-diastolic aortic root diameter is < 40 mm. It seems better to use beta-blockers without intrinsic sympathomimetic activity. Successful acceptance of beta-blockers may be limited by side-effects, but the efficiency of alternative hypotensive agents (calcium channel inhibitors, ACE inhibitors) is not yet validated. Gene therapy might constitute an etiologic specific treatment of MFS. FBN1-RZ1 hammerhead antisense ribozyme is able to suppress expression of the mutant FBN1 allele. The use of ribozymes as systemic therapeutic agents will depend on efficient delivery to its target, but the various proposed vectors raise yet unsolved problems. A hydrogel angioplasty balloon might be a possible vector for delivering an antisense ribozyme in the aortic wall specifically. Ribozymes--as deoxyribonucleotides--may be taken up by tissue upon local application. Further research should study ex vivo local application of antisense ribozyme on human aortic wall, before assessing in vivo efficiency and tolerance of this aortic local vectorisation. It is always necessary to maintain a balanced magnesium intake in patients with MFS. Firstly to prevent the multiple noxious effects of magnesium deficiency on cardiovascular targets. Secondly to ensure the best efficiency and the least toxicity of the hemodynamic drugs used as long term prophylactic treatment for cardiovascular complications and of the etiologic antisense magnesium-dependent gene therapy, in the future.
Authors:
S Igondjo-Tchen; N Pagès; P Bac; G Godeau; J Durlach
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Magnesium research : official organ of the International Society for the Development of Research on Magnesium     Volume:  16     ISSN:  0953-1424     ISO Abbreviation:  Magnes Res     Publication Date:  2003 Mar 
Date Detail:
Created Date:  2003-05-08     Completed Date:  2003-12-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8900948     Medline TA:  Magnes Res     Country:  England    
Other Details:
Languages:  eng     Pagination:  59-64     Citation Subset:  IM    
Affiliation:
Faculté de Chirurgie dentaire, Paris V, 92210 Montrouge, France.
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MeSH Terms
Descriptor/Qualifier:
Cardiovascular Diseases / etiology,  metabolism*,  prevention & control*
Gene Therapy / methods*
Hemodynamics
Humans
Magnesium* / therapeutic use
Magnesium Deficiency / etiology,  prevention & control
Marfan Syndrome / complications,  metabolism*,  therapy*
RNA, Antisense / administration & dosage*
RNA, Catalytic / administration & dosage
Chemical
Reg. No./Substance:
0/RNA, Antisense; 0/RNA, Catalytic; 7439-95-4/Magnesium

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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