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Therapeutic Potential of Rho-Kinase Inhibitors in Cardiovascular Diseases

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Abstract

Rho-kinase is a signaling molecule that occurs downstream of the small GTPase Rho, which mediates various cellular functions. The Rho/Rho-kinase pathway plays an important role in pathophysiology and progression of various cardiovascular diseases such as hypertension, coronary vasospasm, angina pectoris, and restenosis after percutaneous coronary intervention, all of which are related to arteriosclerosis/atherosclerosis changes of the vasculature. Activation of the Rho/Rho-kinase pathway contributes to inflammatory and proliferative changes of the blood vessels and affects cardiac myocytes. Evidence from in vitro and in vivo studies suggests that Rho-kinase inhibitors have beneficial effects on cardiovascular diseases, particularly arteriosclerosis and coronary vasospasm. Furthermore, activation of the Rho/Rho-kinase pathway contributes to blood pressure regulation via the central sympathetic nervous system. There is evidence to suggest that Rho-kinase is involved in angiotensin II-induced cardiac hypertrophy and endothelial dysfunction, and preliminary data indicate that inhibition of Rho-kinase may be beneficial in vascular disorders such as pulmonary arterial hypertension and erectile dysfunction. Fasudil is currently the only Rho-kinase inhibitor available for clinical use and it is approved in Japan for the prevention of vasospasm in patients with subarachnoid hemorrhage. Emerging clinical data have shown that oral fasudil 80mg three times daily is effective in preventing myocardial ischemia in patients with stable angina pectoris. Rho-kinase represents a new target for the management of cardiovascular diseases and further studies are needed to define the therapeutic potential of Rho-kinase inhibitors.

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Acknowledgments

We thank all co-workers at the Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences.

This research was supported by grants-in-aid for scientific research from the Ministry of Education, Science, Sports, and Culture of Japan (A13307024, B12470158, and C13670921). The authors have provided no information on conflicts of interest directly relevant to the content of this review.

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  1. Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan

    Yoshitaka Hirooka & Hiroaki Shimokawa

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  1. Yoshitaka Hirooka
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  2. Hiroaki Shimokawa
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Correspondence to Yoshitaka Hirooka.

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Hirooka, Y., Shimokawa, H. Therapeutic Potential of Rho-Kinase Inhibitors in Cardiovascular Diseases. Am J Cardiovasc Drugs 5, 31–39 (2005). https://doi.org/10.2165/00129784-200505010-00005

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