New Advances in Cardiovascular Drugs: In Memory of Professor Akira Endo

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Drug Discovery, Development and Delivery".

Deadline for manuscript submissions: 31 October 2025 | Viewed by 6675

Special Issue Editor

Special Issue Information

Dear Colleagues,

We dedicate this Special Issue in celebration of the 90th birthday of Prof. Akira Endo, an internationally renowned Japanese biochemist whose research into the relationship between fungi and cholesterol biosynthesis led to the development of the first statin (ML-236B; compactin) 50 years ago, providing a relevant contribution to the advance of cardiovascular pharmacology.

Prof. Akira Endo (born 14 November 1933, in Higashiyuri, Northern Japan) developed an interest in fungi since young age, being an admirer of Alexander Fleming. He degreed from the Faculty of Agriculture at Tokohu University in 1957 and started working as a research fellow in the pharmaceutical company Sankyo, in Tokyo. His research focused on fungal enzymes for processing fruit juice, and, due to successful discoveries in the field, moved to New York after receiving his PhD from the Tokohu University in 1966. In New York, he spent 2 years as a research associate at the Albert Einstein College of Medicine and worked on cholesterol, before returning to Sankyo’s research laboratories in 1968. It was here that Prof. Endo speculated that some fungi might produce antibiotics to inhibit the enzyme responsible for the rate-limiting step in cholesterol synthesis, 3-hydroxy-3-methyl-glutaryl (HMG)-CoA reductase, possibly as a defence mechanism against other microbes. Prof. Endo started his exploratory research in April 1971, analysing about 6000 compounds, and discovered the first statin mevastatin (ML-236B; compactin) in 1973. The wind of change that would have brought such a discovery was not yet known. In fact, at that time, little was known about low-density lipoprotein (LDL) regulation mechanisms since Brown and Goldstein only began their studies that would have led to the discovery of LDL receptor in 1972. As statin research gained attention, other pharmaceutical companies joined in and, in 1978, Merck isolated a compactin-like substance from Aspergillus terreus, whilst, simultaneously, the same compound was discovered by Prof. Endo from Monascus ruber, and lovastatin was born. It took over 10 years preclinical and clinical trials before the approval and commercialization of lovastatin that occurred in 1987 in USA, also paving the way for further statin drugs development.

Prof. Endo became an associate professor in the late 1970s and in 1986 a full professor at Tokyo University of Agriculture and Technology, where he enlightened the minds of young researchers until his retirement. After his official retirement, he became the president of Biopharm Research Laboratories. Thanks to Prof. Endo’s perseverance and enthusiasm in deepening his research, statins are now used to prevent cardiovascular events globally, as well as improving the quality of life of patients.

In this commemorative Special Issue, the scope of which is to detail the advances in cardiovascular drugs in the last few decades, we welcome scientific contributions with the aim of gathering accurate and up-to-date scientific information on laboratory studies of new and upcoming treatment opportunities for cardiovascular diseases. It is my privilege to invite you and your co-workers to share their experience and expertise by submitting original research articles, systematic reviews, and review articles reporting new ideas and recent advances related to this topic.

Dr. Alfredo Caturano
Guest Editor

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Keywords

  • cardiovascular drugs
  • statins
  • metformin
  • SGLT2i
  • laboratory
  • drug targets
  • translational research
  • targeted therapy

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Related Special Issue

Published Papers (7 papers)

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Research

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14 pages, 439 KB  
Article
Evaluating Cardio-Protective Molecules by Efficacy Based on Weight Reduction and HbA1c Targets
by Teodor Salmen, Valeria-Anca Pietrosel, Flaviana-Veronica Urzica, Diana-Elena Visan, Bianca-Margareta Salmen, Radu-Cristian Cimpeanu, Delia Reurean-Pintilei, Mihaela-Simona Popoviciu and Anca Pantea Stoian
Biomedicines 2025, 13(9), 2306; https://doi.org/10.3390/biomedicines13092306 - 20 Sep 2025
Viewed by 176
Abstract
Background: The effectiveness of GLP-1 RAs and SGLT-2i classes, evaluated by a HbA1c target of <7% and body weight reduction (BWR) of 5% in patients with type 2 diabetes mellitus (T2DM), represents the aim of this article. Methods: A retrospective analysis [...] Read more.
Background: The effectiveness of GLP-1 RAs and SGLT-2i classes, evaluated by a HbA1c target of <7% and body weight reduction (BWR) of 5% in patients with type 2 diabetes mellitus (T2DM), represents the aim of this article. Methods: A retrospective analysis was conducted on consecutively admitted out-patients of a tertiary care center for diabetes mellitus (DM) treatment from Romania, where 405 enrolled patients were evaluated at baseline, 6-, and 12-month visits. Results: SGLT-2i were superior to GLP-1 RAs and metformin, providing higher rates of combined target achievements—22.7% at 12 months, p < 0.001. Both HbA1c reduction and BWR were more consistent at the 12-month visit: 6.58% for metformin, 22.68% for SGLT-2i, and 5.88% for GLP-1 Ras, as compared to baseline while the 12-month visit results were as follows: 4.79% for metformin, 5.04% for SGLT-2i and 5.88% for GLP-1 RAs as compared to the 6-month visit. Despite the fact that the HbA1c < 7% target at baseline was 38.92% for metformin, 17.64% for SGLT-2i, and 41.17% for GLP-1 RAs, BWR was achieved less, probably influenced by insulin treatment. Conclusions: This study shows real-world Romanian efficacy and over the time response of administering the new classes in T2DM patients when aiming for HbA1c < 7% levels and 5% BWR, with SGLT-2i outperforming metformin and GLP-1 RAs, emphasizing their growing role in the management of T2DM. Full article
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14 pages, 622 KB  
Article
Effects of Novel Nutraceutical Combination on Lipid Pattern of Subjects with Sub-Optimal Blood Cholesterol Levels
by Nicola Vitulano, Pietro Guida, Vito Abrusci, Edmondo Ceci, Edy Valentina De Nicolò, Stefano Martinotti, Nicola Duni, Federica Troisi, Federico Quadrini, Antonio di Monaco, Massimo Iacoviello, Andrea Passantino and Massimo Grimaldi
Biomedicines 2025, 13(8), 1948; https://doi.org/10.3390/biomedicines13081948 - 9 Aug 2025
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Abstract
Background/Objectives: High concentration of plasma low-density lipoprotein cholesterol (LDL-C) is the predominant cause of atherosclerotic cardiovascular disease progression and coronary heart disease. Nutraceutical combination together with a cholesterol-lowering action provides an alternative to pharmacotherapy in patients reporting intolerance to statins and in [...] Read more.
Background/Objectives: High concentration of plasma low-density lipoprotein cholesterol (LDL-C) is the predominant cause of atherosclerotic cardiovascular disease progression and coronary heart disease. Nutraceutical combination together with a cholesterol-lowering action provides an alternative to pharmacotherapy in patients reporting intolerance to statins and in subjects with low cardiovascular risk. The effects on lipid parameters were evaluated over 6 months for a food supplement containing aqueous extract of Berberis aristata and Olea europea, fenugreek seed extract, water/ethanol extract of artichoke leaf and phytosterols from sunflower seeds (Ritmon Colesystem®). Methods: Laboratory data were obtained at baseline from 44 otherwise healthy subjects (33 males, mean 50 ± 11 years) without cardiovascular disease having LDL-C in the range 115 to 190 mg/dL pharmacologically untreated for hypercholesterolemia. Subjects were re-evaluated at 1, 3 and 6 months during which they took one tablet of Ritmon Colesystem® after dinner. Results: At baseline, the mean values were 151 ± 21 mg/dL for LDL-C, 223 ± 24 mg/dL for total cholesterol (T-C), 52 ± 14 mg/dL for high-density lipoprotein cholesterol (HDL-C), and 124 ± 58 mg/dL for triglycerides. A significant reduction in LDL-C was observed; 9 mg/dL (95% confidence interval 3–14), 10 (4–17) and 7 (1–14) at 1, 3 and 6 months. A similar significant trend was detected for T-C while triglycerides did not show significant changes and HDL-C had lower values only at 3 months. Conclusions: These nutraceuticals in individuals with sub-optimal blood cholesterol levels at intermediate–low cardiovascular risk reduced LDL-C and T-C over 6 months contributing to the improvement of cholesterol control by dietary supplements. Full article
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15 pages, 1845 KB  
Article
In Vitro Investigation of Statin Effects on Genes Associated with Severe COVID-19 in Cancerous and Non-Cancerous Cells
by Adriana Kapustová, Patrik Macášek, Bibiána Baďurová, Jana Melegová, Silvie Rimpelová, Jan Kubovčiak, Jana Šáchová, Miluše Hradilová, Michal Kolář, Libor Vítek, Tomáš Ruml and Helena Gbelcová
Biomedicines 2025, 13(7), 1714; https://doi.org/10.3390/biomedicines13071714 - 14 Jul 2025
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Abstract
Background: The progressive course of coronavirus disease 2019 (COVID-19) is more frequently observed in individuals with obesity, diabetes, pulmonary and cardiovascular disease, or arterial hypertension. Many patients with these conditions are prescribed statins to treat hypercholesterolaemia. However, statins exhibit additional pleiotropic effects. The [...] Read more.
Background: The progressive course of coronavirus disease 2019 (COVID-19) is more frequently observed in individuals with obesity, diabetes, pulmonary and cardiovascular disease, or arterial hypertension. Many patients with these conditions are prescribed statins to treat hypercholesterolaemia. However, statins exhibit additional pleiotropic effects. The present study aims to investigate the effects of all eight currently existing statins on the expression of genes whose products have been reported to be directly associated with complicated COVID-19 disease. Methods: We extended the interpretation of the whole-genome DNA microarray analyses of pancreatic cancer cells MiaPaCa-2 and whole-transcriptome analyses of adipose tissue-derived mesenchymal stem cells AD-MSC that we had performed in the past. From the number of genes with altered expression induced by statins, we focused on those reported to be involved in a complicated course of COVID-19, including APOE and ACE2, genes encoding proteins involved in innate antiviral immunity and respiratory failure genes. Results: Although we did not observe statin-induced changes in the expression of APOE, ACE2 and any of the six genes clustered in the locus associated with respiratory failure in patients with COVID-19, some statins induced changes in the expression of genes encoding their interaction partners. Among genes associated with the immune system, all statins, which are effective in vitro affected the expression of genes encoding IL-6 and IL-8 and interaction partners of NF-kB, which may influence the duration of viral persistence. Conclusions: Statins act on multiple pathways simultaneously, some of which support COVID-19 development, while others suppress it. Full article
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Review

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22 pages, 1721 KB  
Review
The Heart in Space: Effects of Microgravity on Different Cell Types and Their Functions in the Cardiovascular System
by Zenab Shahzad, Ramish H. Rafay, Niharika Bala, Yunus E. Dogan and Abdel A. Alli
Biomedicines 2025, 13(10), 2336; https://doi.org/10.3390/biomedicines13102336 - 24 Sep 2025
Viewed by 75
Abstract
Space travel may have promising implications for innovative approaches in biomedical research. But there are potential challenges and health concerns associated with exposures from space travel that warrant the need for mechanistic studies to determine the effects on various organ systems including the [...] Read more.
Space travel may have promising implications for innovative approaches in biomedical research. But there are potential challenges and health concerns associated with exposures from space travel that warrant the need for mechanistic studies to determine the effects on various organ systems including the cardiovascular system. Radiation exposure associated with space flight is known to adversely affect the heart and vascular system. However, less is known about the effects of microgravity on the cardiovascular system. Various functions of the cardiovascular system may be affected by microgravity. Studies have investigated changes in the cytoskeleton of various cell types in response to simulated microgravity. Other studies investigated the effect of microgravity on the permeability and migration of endothelial cells and myocardial atrophy associated with endothelial dysfunction. In addition, coagulation, vasoconstriction, blood volume, and cardiac dimensions were outcome measures of studies aimed at understanding the implications of microgravity on the cardiovascular system. This comprehensive review summarizes the effect of microgravity on various aspects of the cardiovascular system. Full article
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23 pages, 1852 KB  
Review
Contemporary and Emerging Therapeutics in Cardiovascular-Kidney-Metabolic (CKM) Syndrome: In Memory of Professor Akira Endo
by Inderjeet Singh Bharaj, Ajit Brar, Aayushi Kacheria, Karen Purewal, Austin Simister, Umabalan Thirupathy, Palak Gupta, Jasraj Kahlon, Juzer Munaim, Ei Ei Thwe, Samer Ibrahim, Valerie Martinez Vargas and Krishnaswami Vijayaraghavan
Biomedicines 2025, 13(9), 2192; https://doi.org/10.3390/biomedicines13092192 - 8 Sep 2025
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Abstract
Cardiovascular-kidney-metabolic (CKM) syndrome is a multifaceted, systemic disorder characterized by the interplay of cardiovascular disease (CVD), chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and obesity. This review synthesizes current and emerging therapeutic strategies aimed at addressing the shared pathophysiologic mechanisms driving [...] Read more.
Cardiovascular-kidney-metabolic (CKM) syndrome is a multifaceted, systemic disorder characterized by the interplay of cardiovascular disease (CVD), chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and obesity. This review synthesizes current and emerging therapeutic strategies aimed at addressing the shared pathophysiologic mechanisms driving CKM progression, such as insulin resistance, inflammation, oxidative stress, and neurohormonal activation. Established pharmacotherapies that include sodium-glucose cotransporter 2 (SGLT2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and nonsteroidal mineralocorticoid receptor antagonists like finerenone have demonstrated robust efficacy in reducing cardiovascular events, slowing renal decline, and improving metabolic outcomes. Additionally, novel agents targeting lipoprotein(a), interleukin-6, and hepatic fat accumulation are expanding the therapeutic landscape. RNA-based therapies, including antisense oligonucleotides (ASOs) and small interfering RNAs (siRNAs), are designed to modulate lipoprotein(a) and PCSK9 expression. Artificial intelligence (AI) is also emerging as a transformative tool for personalized CKM management, enhancing risk prediction and clinical decision-making. The review highlights the relevance of metabolic dysfunction-associated steatotic liver disease (MASLD) as a CKM modifier and discusses the approval of resmetirom, a selective thyroid hormone receptor β agonist, for noncirrhotic MASH. By integrating evidence from clinical trials, mechanistic studies, and emerging technologies, this review provides a comprehensive resource for clinicians and researchers navigating the evolving field of CKM syndrome. Full article
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21 pages, 594 KB  
Review
PEDF and Its Role in Metabolic Disease, Angiogenesis, Cardiovascular Disease, and Diabetes
by Crispin R. Dass
Biomedicines 2025, 13(7), 1780; https://doi.org/10.3390/biomedicines13071780 - 21 Jul 2025
Cited by 1 | Viewed by 809
Abstract
This review highlights recent findings on the potent anti-angiogenic serpin protein, pigment epithelium-derived factor (PEDF) as it relates to metabolic disease, diabetes, angiogenesis and cardiovascular disease (CVD), listing a majority of all the publicly available studies reported to date. PEDF is involved in [...] Read more.
This review highlights recent findings on the potent anti-angiogenic serpin protein, pigment epithelium-derived factor (PEDF) as it relates to metabolic disease, diabetes, angiogenesis and cardiovascular disease (CVD), listing a majority of all the publicly available studies reported to date. PEDF is involved in various physiological roles in the body, and when awry, it triggers various disease states clinically. Biomarkers such as insulin, AMP-activated protein kinase alpha (AMPK-α), and peroxisome proliferator-activated receptor gamma (PPAR-γ) are involved in PEDF effects on metabolism. Wnt, insulin receptor substate (IRS), Akt, extracellular signal-regulated kinase (ERK), and mitogen-activated protein kinase (MAPK) are implicated in diabetes effects displayed by PEDF. For CVD, oxidised LDL, Wnt/β-catenin, and reactive oxygen species (ROS) are players intertwined with PEDF activity. The review also presents an outlook on where efforts could be devoted to bring this serpin closer to clinical trials for these diseases and others in general. Full article
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23 pages, 1705 KB  
Review
Lysosomal Stress in Cardiovascular Diseases: Therapeutic Potential of Cardiovascular Drugs and Future Directions
by Toshiki Otoda, Ken-ichi Aihara and Tadateru Takayama
Biomedicines 2025, 13(5), 1053; https://doi.org/10.3390/biomedicines13051053 - 27 Apr 2025
Cited by 3 | Viewed by 1437
Abstract
Lysosomal dysfunction has emerged as a central contributor to the pathogenesis of cardiovascular diseases (CVDs), particularly due to its involvement in chronic inflammation, lipid dysregulation, and oxidative stress. This review highlights the multifaceted roles of lysosomes in CVD pathophysiology, focusing on key mechanisms [...] Read more.
Lysosomal dysfunction has emerged as a central contributor to the pathogenesis of cardiovascular diseases (CVDs), particularly due to its involvement in chronic inflammation, lipid dysregulation, and oxidative stress. This review highlights the multifaceted roles of lysosomes in CVD pathophysiology, focusing on key mechanisms such as NLRP3 inflammasome activation, TFEB-mediated autophagy regulation, ferroptosis, and the role of apolipoprotein M (ApoM) in preserving lysosomal integrity. Additionally, we discuss how impaired lysosomal acidification, mediated by V-ATPase, contributes to lipid-induced cardiac dysfunction. Therapeutically, several pharmacological agents, such as statins, SGLT2 inhibitors, TRPML1 agonists, resveratrol, curcumin, and ferroptosis modulators (e.g., GLS1 activators and icariin), have demonstrated promise in restoring lysosomal function, enhancing autophagic flux, and reducing inflammatory and oxidative injury in both experimental models and early clinical settings. However, key challenges remain, including limitations in drug delivery systems, the absence of lysosome-specific biomarkers, and insufficient clinical validation of these strategies. Future research should prioritize the development of reliable diagnostic tools for lysosomal dysfunction, the optimization of targeted drug delivery, and large-scale clinical trials to validate therapeutic efficacy. Incorporating lysosome-modulating approaches into standard cardiovascular care may offer a new precision medicine paradigm for managing CVD progression. Full article
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