Pharmacological inhibition of poly(ADP-ribose) polymerase in cardiovascular disorders: future directions

Poly(ADP-ribose) polymerase (PARP) activation plays a role in the pathogenesis of various cardiovascular and inflammatory diseases. Reactive oxygen and nitrogen species induce DNA single strand breaks, which serve as obligatory triggers for the activation of PARP. Pharmacological inhibitors of PARP attenuate ischemic and inflammatory cell and organ injury, and this property of the PARP inhibitors can be exploited for the experimental therapy of disease. As several classes of PARP inhibitors move towards clinical development, or have already entered clinical trials, we expect that in the upcoming few years, clinical proof of PARP inhibitors' therapeutic effect will be obtained in human disease. Acute, life-threatening cardiovascular diseases (myocardial infarction, cardiopulmonary bypass in high-risk patients, and other, severe forms of ischemia-reperfusion to other organs including stroke and thoracoabdominal aneurysm repair) represent some of the initial development indications for PARP inhibitors.