AccScience Publishing / AN / Volume 1 / Issue 3 / DOI: 10.36922/an.v1i3.211
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REVIEW

Potential therapeutic targets and medications for arteriovenous malformations of the central nervous system

Zhengsong Li1,2 Yueshan Feng1,2 Shiju Zhang1,2 Yuan Zhou1,2 Jiaxing Yu1,2 Hongqi Zhang1,2 Tao Hong1,2*
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1 Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
2 International Neuroscience Institute, Beijing, China
Advanced Neurology 2022, 1(3), 211 https://doi.org/10.36922/an.v1i3.211
Submitted: 29 September 2022 | Accepted: 29 November 2022 | Published: 19 December 2022
© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
Abstract

Arteriovenous malformations (AVMs) of the central nervous system are high-flow arteriovenous shunts that lead to considerable risks of hemorrhagic stroke and neurological deficits in young patients. Due to the complex angioarchitecture and their close anatomical relationship with the brain and spinal cord, the management of brain and spinal AVMs is challenging. Conventional invasive treatments, including microsurgery, endovascular embolization, and stereotactic radiosurgery, are associated with considerable risks and unsatisfactory efficacy. In addition, the lack of medications for AVMs represents an unmet clinical need. In recent years, the pathogenesis of AVMs has been progressively explored. The increased understanding of the mechanisms of the formation, progression, and rupture of AVMs has opened up several potential directions for AVM pharmacotherapy. In recent years, some promising drugs targeting angiogenesis, inflammation, vessel wall integrity, and the mitogen-activated protein kinase (MAPK)-extracellular receptor kinase (ERK) signaling pathway have been tested in a series of clinical investigations. In this review, we summarize the potential mechanisms, preliminary efficacy, and side effects of the candidate medications, including bevacizumab, minocycline or doxycycline, thalidomide, and trametinib, in the treatment of brain and spinal AVMs.

Keywords
Arteriovenous malformations
Therapeutic targets
Medication
Vascular integrity
Somatic mutations
Funding
None.
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Conflict of interest
The authors declare that they have no competing interests.
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