Inflammation and cardiovascular disease: From mechanisms to therapeutics.

Inflammation and cardiovascular disease: From mechanisms to therapeutics.
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炎症和心血管疾病:从机制到治疗学。

DOI:
10.1016/j.ajpc.2020.100130
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发表时间:
2020-12
影响因子:
4.1
通讯作者:
Toth PP
Toth PP
中科院分区:
其他
文献类型:
--
作者:
Alfaddagh A;Martin SS;Leucker TM;Michos ED;Blaha MJ;Lowenstein CJ;Jones SR;Toth PP

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炎症是一个复杂的、高度保守的分子和细胞级联反应。炎症被称为“内在之火”,受到高度调控,对宿主防御和组织修复至关重要。一般来说,炎症是有益的,并已发展到促进生存。然而,炎症在慢性激活和持续时也可能是适应不良的,导致进行性组织损伤和存活率降低。适应不良反应的例子包括风湿病和动脉粥样硬化。尽管Virchow在100多年前收集的证据表明炎性白色细胞在动脉粥样硬化形成中起作用,但动脉粥样硬化直到最近才被视为一种内皮下胆固醇被动积聚的疾病。这一观点已被大量的基础科学和临床证据所取代,这些证据表明,动脉粥样硬化形成的每一步,从内皮细胞功能障碍的发展到泡沫细胞形成、斑块形成和进展,以及最终源于结构不稳定的斑块破裂,都是由细胞因子、白介素和炎症反应的细胞成分驱动的。本文综述了炎症在动脉粥样硬化性心血管疾病中的作用,讨论了炎症相关的各种生物标志物的预测价值,并总结了最近的临床试验,这些试验评估了各种药物干预措施减轻炎症强度和影响急性心血管事件风险的能力。
Inflammation constitutes a complex, highly conserved cascade of molecular and cellular events. Inflammation has been labeled as “the fire within,” is highly regulated, and is critical to host defense and tissue repair. In general, inflammation is beneficial and has evolved to promote survival. However, inflammation can also be maladaptive when chronically activated and sustained, leading to progressive tissue injury and reduced survival. Examples of a maladaptive response include rheumatologic disease and atherosclerosis. Despite evidence gathered by Virchow over 100 years ago showing that inflammatory white cells play a role in atherogenesis, atherosclerosis was until recently viewed as a disease of passive cholesterol accumulation in the subendothelial space. This view has been supplanted by considerable basic scientific and clinical evidence demonstrating that every step of atherogenesis, from the development of endothelial cell dysfunction to foam cell formation, plaque formation and progression, and ultimately plaque rupture stemming from architectural instability, is driven by the cytokines, interleukins, and cellular constituents of the inflammatory response. Herein we provide an overview of the role of inflammation in atherosclerotic cardiovascular disease, discuss the predictive value of various biomarkers involved in inflammation, and summarize recent clinical trials that evaluated the capacity of various pharmacologic interventions to attenuate the intensity of inflammation and impact risk for acute cardiovascular events.
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