PRECISION MEDICINE FOR TODAY AND TOMORROW: TARGETING MOLECULAR PATHWAYS FOR VASCULAR DISEASE


Kenneth Maiese, M.D., University of Medicine & Dentistry of New Jersey, Newark, NJ, USA

Molecular targeting is becoming increasing recognized as a necessary means for drug development and the successful treatment of an individual’s disease onset and progression. Although multiple pathways can be responsible for cardiac or vascular disorders in patients, kinase pathways in the vascular system that involve phosphoinositide 3-kinase (PI 3-K), protein kinase B (Akt), and the mammalian target of rapamycin (mTOR) offer especially exciting prospects for developing strategies for disease in the cardiovascular system. PI 3-K, Akt, and mTOR pathways including the protein complexes mTORC1 and mTORC2 not only determine cellular survival during acute and chronic disorders, but also maintain a complex relationship over the control of cellular regenerative pathways that involve apoptosis and autophagy that can lead to a variety of clinical outcomes. These molecular pathways partner with novel signal transduction mechanisms, such as wingless and growth factors, to modulate endothelial and cardiomyocyte development and growth as well as the interaction of vascular cells with inflammatory processes. Our work identifies the kinase signaling pathways of PI 3-K, Akt, and mTOR with their molecular cellular partners as new prospects for the treatment of vascular disease. Further investigation and knowledge of these pathways can offer precision targeting for the development of novel strategies for patients suffering from disorders of the cardiovascular system.