The role of polysaccharide polymers in the regulation of angiogenesis and atherogenic inflammation in the vascular wall. Literature review. Part 2

The aim of the study. To determine the therapeutic possibilities of local activation of angiogenesis and degradation of atherogenic inflammation during reconstruction of arterial wall layers under conditions of wide implantation of polysaccharide polymers in the para-adventitial zone. The concept of the analytical review is based on the hypothesis of improving the balance between pro-inflammatory and atheroprotective cytokine growth factors when using biopolymers. Materials and methods. The analysis of the literature indicates an active direct intervention in the reconstruction of the adventitial layer of the arterial wall using polysaccharide hydrogels with a high affinity for cholesterol, conditions are created for the formation of an additional extracellular matrix outside the intimal and middle zones of the main artery and the reversal of the cholesterol mass from the intimal zone to the paraadventitial space. The creation of productive inflammation in the adventitial zone using biopolymers can be one of the effective ways to degrade early soft atherogenic plaques. Publications indicate the possibility of extracting soft atherogenic plaques from the intimal space of major arteries by wide implantation of polysaccharide hydrogels into the fascial sheath of vessels with the formation of a second-level extracellular matrix. The analysis of literary sources according to the concept was carried out using databases indexed by WoS, Scopus, PubMed, DOAJ, Embase, Ei Compendex mainly for the last 10 years. Results. The literature review allows us to form a modern understanding of the molecular processes occurring in the vessel wall during the development of atherogenic inflammation in an experiment on animals receiving a cholesterol diet, to indicate signs of vascular wall reconstruction with exogenous implantation of biopolymers. Conclusions. In the vascular wall, there is a conjugation of cytokine growth factors with natural or synthetic biomaterials. Immobilized factors will be available to cells that come into contact with the matrix, providing a highly localized signal to control cell fate. Injectable scaffolds are a promising approach for stimulating angiogenesis. Cell migration from the intima and media can be activated by an electrostatic gradient in the presence of a sulfated polymer and lead to the formation of affinity complexes with cholesterol. The high affinity of polysaccharide polymers for cholesterol and LDL, active vascularization of the additional extracellular matrix provoke a gradient of cholesterol translation towards the hydrogel “shirt”. The effect of cholesterol outflow can provide a new therapeutic approach to the pathology of the main vessels.

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