The concept that inflammation participates pivotally in the pathogenesis of atherosclerosis and its complications has gained considerable attention, but has not yet entered clinical practice. Experimental work has elucidated molecular and cellular pathways of inflammation that promote atherosclerosis. The recognition of atherogenesis as an active process rather than a cholesterol storage disease or a repository of calcium has highlighted some key inflammatory mechanisms. For example, mononuclear phagocytes contribute to all stages of this disease, illustrating the link between inflammation and atherosclerosis. From a clinical perspective, harnessing inflammation may now help target therapeutics, change guidelines, and enter daily practice. Multiple lines of incontrovertible evidence have proven a causal role for low-density lipoprotein (LDL) cholesterol in atherosclerosis, and we have highly effective tools for lowering LDL, consequently reducing events. Yet, even with intense LDL reduction, events still occur. Inflammation can explain some of this residual risk. An anti-inflammatory intervention has now proven capable of improving outcomes in individuals well treated with LDL-lowering agents. A suite of trials are now pursuing anti-inflammatory therapies in this context. Assessment and treatment of residual inflammatory risk are poised to provide new inroads into preventive cardiology. This brief review aims to explore the potential mechanisms underlying the association of inflammation and atherogenesis, and their clinical consequences.
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June 2018
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Double immunofluorescence staining for mindin (red) and CD68 (green) in atherosclerotic plaques of HFD-treated APOE-/- mice. In Issue 11 of Clinical Science, Zhu et al. discuss mindin deficiency as a novel mediator in protecting against foam cell formation and atherosclerosis, through direct interaction with LXR-β; for details, see pages 1199–1213.
Review Article|
June 21 2018
Atherosclerosis and inflammation: overview and updates
Glaucylara Reis Geovanini;
1Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil
Correspondence: Glaucylara Reis Geovanini ([email protected])
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Peter Libby
Peter Libby
2Cardiovascular Division, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, U.S.A.
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Publisher: Portland Press Ltd
Received:
April 11 2018
Revision Received:
May 08 2018
Accepted:
May 10 2018
Online ISSN: 1470-8736
Print ISSN: 0143-5221
© 2018 The Author(s). Published by Portland Press Limited on behalf of the Biochemical Society
2018
Clin Sci (Lond) (2018) 132 (12): 1243–1252.
Article history
Received:
April 11 2018
Revision Received:
May 08 2018
Accepted:
May 10 2018
Citation
Glaucylara Reis Geovanini, Peter Libby; Atherosclerosis and inflammation: overview and updates. Clin Sci (Lond) 29 June 2018; 132 (12): 1243–1252. doi: https://doi.org/10.1042/CS20180306
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