Cardiovascular disease,
nervous system disorders, and
cancer in association with other diseases such as
diabetes mellitus result in greater than sixty percent of the global annual deaths. These
noncommunicable diseases also affect at least one-third of the population in low and middle-income countries and lead to
hypertension,
elevated cholesterol,
malignancy, and
neurodegenerative disorders such as
Alzheimer's disease and
stroke. With the climbing lifespan of the world's population, increased prevalence of these disorders is expected requiring the development of new therapeutic strategies against these disabling disease entities. Targeting stem cell proliferation for
cardiac disease, vascular disorders,
cancer, and
neurodegenerative disorders is receiving great enthusiasm, especially those that focus upon
SIRT1, a mammalian homologue of the yeast silent information regulator-2. Modulation of the cellular activity of
SIRT1 can involve oversight by
nicotinamide/
nicotinic acid mononucleotide adenylyltransferase, mammalian
forkhead transcription factors, mechanistic of
rapamycin pathways, and
cysteine-rich protein 61,
connective tissue growth factor, and
nephroblastoma over-expressed gene family members that can impact cytoprotective outcomes. Ultimately, the ability of
SIRT1 to control the programmed cell death pathways of apoptosis and autophagy can determine not only cardiac, vascular, and neuronal stem cell development and longevity, but also the onset of
tumorigenesis and the resistance against
chemotherapy.
SIRT1 therefore has a critical role and holds exciting prospects for new therapeutic strategies that can offer reparative processes for cardiac, vascular, and nervous system degenerative disorders as well as targeted control of aberrant cell growth during
cancer.