Abstract
Abdominal aortic aneurysm (AAA) is a common disease and a major cause of death through rupture, the risk of which increases with aneurysm size. There is approximately a 5 year interval from when aneurysmal dilatation develops until it reaches a size where surgery is indicated. Slowing, or arresting, aneurysm growth during this period would be beneficial. Aneurysmal aortic wall degeneration is a multifactorial, chronic inflammatory process resulting via activation of matrix metalloproteinases (MMPs), in destruction of mural connective tissue. Doxycycline, a tetracycline antibiotic, is a known inhibitor of MMPs. Animal studies of doxcycline for AAA provide significant evidence of a beneficial effect. However, the human studies, comprising 6 controlled trials and 2 cohort studies, provide conflicting evidence. They are generally of poor methodological quality with small numbers (just 255 subjects analyzed), lack of adjustment for confounding variables, short term doxycycline exposure and a lack of long term follow up. Standardization of dose (per unit weight) and confirmation of compliance remain other systemic failings. The safety of long-term doxycycline use is yet to be proved. The evidence for any beneficial effect of doxycycline as a treatment for AAA, therefore, remains weak. Further studies are required and will ideally be multicentre, involve large subject numbers and be of high quality randomization and blinding with longer periods of doxycycline exposure, confirmation of compliance, standardization of confounding variables and prolonged follow up.
Keywords: Abdominal aortic aneurysm, doxycycline, matrix metalloproteinase, inflammation, angiogenesis, apoptosis, metal chelation, bone metabolism, randomized controlled trial, reverse transcriptase polymerase chain reaction
Current Vascular Pharmacology
Title: Doxycycline Inhibition of Abdominal Aortic Aneurysm Growth - A Systematic Review of the Literature
Volume: 9 Issue: 4
Author(s): Benjamin R. Dodd and Roy A. Spence
Affiliation:
Keywords: Abdominal aortic aneurysm, doxycycline, matrix metalloproteinase, inflammation, angiogenesis, apoptosis, metal chelation, bone metabolism, randomized controlled trial, reverse transcriptase polymerase chain reaction
Abstract: Abdominal aortic aneurysm (AAA) is a common disease and a major cause of death through rupture, the risk of which increases with aneurysm size. There is approximately a 5 year interval from when aneurysmal dilatation develops until it reaches a size where surgery is indicated. Slowing, or arresting, aneurysm growth during this period would be beneficial. Aneurysmal aortic wall degeneration is a multifactorial, chronic inflammatory process resulting via activation of matrix metalloproteinases (MMPs), in destruction of mural connective tissue. Doxycycline, a tetracycline antibiotic, is a known inhibitor of MMPs. Animal studies of doxcycline for AAA provide significant evidence of a beneficial effect. However, the human studies, comprising 6 controlled trials and 2 cohort studies, provide conflicting evidence. They are generally of poor methodological quality with small numbers (just 255 subjects analyzed), lack of adjustment for confounding variables, short term doxycycline exposure and a lack of long term follow up. Standardization of dose (per unit weight) and confirmation of compliance remain other systemic failings. The safety of long-term doxycycline use is yet to be proved. The evidence for any beneficial effect of doxycycline as a treatment for AAA, therefore, remains weak. Further studies are required and will ideally be multicentre, involve large subject numbers and be of high quality randomization and blinding with longer periods of doxycycline exposure, confirmation of compliance, standardization of confounding variables and prolonged follow up.
Export Options
About this article
Cite this article as:
R. Dodd Benjamin and A. Spence Roy, Doxycycline Inhibition of Abdominal Aortic Aneurysm Growth - A Systematic Review of the Literature, Current Vascular Pharmacology 2011; 9 (4) . https://dx.doi.org/10.2174/157016111796197288
DOI https://dx.doi.org/10.2174/157016111796197288 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Advancements in Arterial Stiffness: Novel Therapeutic Frontiers
Arterial stiffness, a hallmark of cardiovascular disease, poses significant challenges in contemporary healthcare. This thematic issue delves into the multifaceted landscape of arterial stiffness and explores cutting-edge therapeutic interventions aimed at mitigating its adverse effects. Within these pages, readers will find a comprehensive overview of the mechanisms underlying arterial stiffness, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Significance of Hemodynamics Biomarkers, Tissue Biomechanics and Numerical Simulations in the Pathogenesis of Ascending Thoracic Aortic Aneurysms
Current Pharmaceutical Design An Update on the Role of the Quality of LDL in Cardiovascular Risk:The Contribution of the Universities of Palermo and Zurich
Recent Patents on Cardiovascular Drug Discovery Is Hospital Autopsy Auditing Suitable for Clinical Risk Manage ment? Actualities and Perspectives of Auditing in the Autopsy Room Following Italian Law 24/2017 on Patient Safety
Current Pharmaceutical Biotechnology Association of Circulating Cholesterol Level with Cognitive Function and Mild Cognitive Impairment in the Elderly: A Community-based Population Study
Current Alzheimer Research Safety and Efficacy of Intracoronary Human Umbilical Cord-Derived Mesenchymal Stem Cell Treatment for Very Old Patients with Coronary Chronic Total Occlusion
Current Pharmaceutical Design Evaluation of Application Value of Transcranial Doppler (TCD) in the Inspection of Cerebral Vasospasm After the Treatment of Intracranial Aneurysm
Current Medical Imaging Multimodality Imaging in Acute Ischemic Stroke
Current Medical Imaging Safety of Intravenous Thrombolysis in Ischemic Stroke Caused by Left Atrial Myxoma
Current Drug Safety Development of Nucleic Acid Drugs for Neurological Disorders
Current Topics in Medicinal Chemistry The Brain, the Penis and Steroid Hormones: Clinical Correlates with Endothelial Dysfunction
Current Pharmaceutical Design Analytical Solutions to Bloch NMR Flow Equation in Porous System: Future and Emerging Magnetic Resonance Computational Imaging for Medical and Biomedical Engineering
Recent Patents and Topics on Imaging (Discontinued) Significant Association of CXCL12 rs1746048 with LDL-C Level in Intracranial Aneurysms
Current Neurovascular Research Inhibition of Matrix Metalloproteinases (MMPs) as a Potential Strategy to Ameliorate Hypertension-Induced Cardiovascular Alterations
Current Drug Targets Long-Term Extensions of Randomized Vaccination Trials of ACC-001 and QS-21 in Mild to Moderate Alzheimer’s Disease
Current Alzheimer Research Genetic Variability of Matrix Metalloproteinase Genes in Cardiovascular Disease
Current Topics in Medicinal Chemistry Sp/KLF Family and Tumor Angiogenesis in Pancreatic Cancer
Current Pharmaceutical Design Anti-Inflammatory Activity of Tetracyclines: Applications to Human Disease
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Kawasakis Disease, Acrodynia, and Mercury
Current Medicinal Chemistry Intracranial Aneurysms in Sickle Cell Disease
Current Neurovascular Research Mitral Valve Prolapse and Sudden Cardiac Death in Athletes at High Risk
Current Cardiology Reviews