Grapevine

Nanoparticle technology shows promise for targeted diagnosis and treatment of atherosclerosis

Atherosclerosis is the build-up of plaque in the arteries which causes their narrowing. It is a primary cause of ischemic heart disease (IHD) and ischemic stroke (IS), both of which are major contributors to the 17.9 million deaths caused by cardiovascular diseases each year globally. The incidence of atherosclerosis-related conditions has been rising steadily over the past three decades, and particularly in younger populations. The increase is driven by lifestyle factors such as unhealthy diets, lack of exercise, smoking, and alcohol consumption.

In Singapore, cardiovascular diseases (CVDs) are a leading cause of mortality, accounting for 31% of deaths in 2022, and a projected three times increase in obesity-related heart attacks by 2050.

Commonly used methods for imaging atherosclerotic plaques include techniques like intravascular ultrasound, coronary angiography, computed tomography angiography and magnetic resonance imaging (MRI). However, these methods have limitations in resolution, invasiveness, and most importantly, the ability to deliver targeted therapies.

Intravascular ultrasound, utilizes an ultrasound probe on a catheter inside the blood vessel to visualize the walls of the arteries for a detailed assessment of the extent and nature of the plaques. However, this method is invasive and applies only to larger blood vessels with limited spatial resolution Coronary angiography, uses X-ray imaging and an injection of a dye that provides contrast for visualizing arteries and detecting blockages caused by plaque. Similar to X-ray coronary angiography, computed tomography angiography, which uses ionizing radiation and an injection of a dye to obtain more detailed images of blood vessels. MRI provides the highest-resolution images of blood vessel and plaque morphology among all the four imaging techniques.

There are currently no medications or treatments that can specifically target atherosclerotic plaques, to significantly reduce plaque burden or reverse atherosclerosis. Patients with high CVD risk are generally prescribed medications that can stabilize plaques, including statins that lower cholesterol levels, anti-platelet agents such as aspirin to reduce the risk of clots forming at the site of plaques, while ace inhibitors and beta-blockers are used to manage high blood pressure.