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We undertook a literature search for studies of Marfan syndrome, to identify milestones in description, understanding and therapy of the syndrome. From the studies retrieved we then weaved an evidence\u2010based description of progress. Marfan syndrome shows considerable heterogeneity in clinical presentation. It relies on defined clinical criteria with confirmation based on <jats:italic>FBN1<\/jats:italic> mutation testing. Surgical advances have prolonged life in Marfan syndrome. First\u2010line prophylaxis of complications with \u03b2\u2010adrenoceptor blockers became established on the basis that reduction of aortic pressure and heart rate would help. Over\u2010activity of proteinases, first suggested in 1980, has since been confirmed by evidence of over\u2010expression of matrix metalloproteinases (MMP), notably <jats:italic>MMP\u20102<\/jats:italic> and <jats:italic>MMP\u20109<\/jats:italic>. The search for MMP inhibitors led to the evaluation of doxycycline, and both animal studies and small trials, provided early evidence that this widely used antimicrobial agent was useful. Identification of the importance of TGF\u2010\u03b2 led to evaluation of angiotensin II type I receptor (AT<jats:sub>1<\/jats:sub>R) blockers with highly promising results. Combination prophylactic therapy would appear rational. Pharmacological and genomic research has provided good evidence that therapy with losartan and doxycycline would prevent the aortic complications of Marfan syndrome. If on\u2010going well designed trials confirm their efficacy, the outlook for Marfan syndrome patients would be improved considerably.<\/jats:p>","DOI":"10.1111\/j.1365-2125.2011.03929.x","type":"journal-article","created":{"date-parts":[[2011,1,29]],"date-time":"2011-01-29T08:43:16Z","timestamp":1296290596000},"page":"6-17","source":"Crossref","is-referenced-by-count":9,"title":["Preventing the aortic complications of Marfan syndrome: a case\u2010example of translational genomic 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