Hypercholesterolemia and inflammation-Cooperative cardiovascular risk factors.

IF 4.4 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Antonio Gallo, Wilfried Le Goff, Raul D Santos, Isabella Fichtner, Stefano Carugo, Alberto Corsini, Cesare Sirtori, Massimiliano Ruscica
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Abstract

Background: Maintaining low concentrations of plasma low-density lipoprotein cholesterol (LDLc) over time decreases the number of LDL particles trapped within the artery wall, slows the progression of atherosclerosis and delays the age at which mature atherosclerotic plaques develop. This substantially reduces the lifetime risk of atherosclerotic cardiovascular disease (ASCVD) events. In this context, plaque development and vulnerability result not only from lipid accumulation but also from inflammation.

Results: Changes in the composition of immune cells, including macrophages, dendritic cells, T cells, B cells, mast cells and neutrophils, along with altered cytokine and chemokine release, disrupt the equilibrium between inflammation and anti-inflammatory mechanisms at plaque sites. Considering that it is not a competition between LDLc and inflammation, but instead that they are partners in crime, the present narrative review aims to give an overview of the main inflammatory molecular pathways linked to raised LDLc concentrations and to describe the impact of lipid-lowering approaches on the inflammatory and lipid burden. Although remarkable changes in LDLc are driven by the most recent lipid lowering combinations, the relative reduction in plasma C-reactive protein appears to be independent of the magnitude of LDLc lowering.

Conclusion: Identifying clinical biomarkers of inflammation (e.g. interleukin-6) and possible targets for therapy holds promise for monitoring and reducing the ASCVD burden in suitable patients.

高胆固醇血症和炎症--合作性心血管风险因素。
背景:长期保持低浓度的血浆低密度脂蛋白胆固醇(LDLc)可减少动脉壁内滞留的低密度脂蛋白颗粒的数量,减缓动脉粥样硬化的进展,并推迟形成成熟动脉粥样硬化斑块的年龄。这大大降低了终生罹患动脉粥样硬化性心血管疾病(ASCVD)的风险。在这种情况下,斑块的形成和易损性不仅源于脂质积累,还源于炎症:结果:免疫细胞(包括巨噬细胞、树突状细胞、T 细胞、B 细胞、肥大细胞和中性粒细胞)组成的变化,以及细胞因子和趋化因子释放的改变,打破了斑块部位炎症和抗炎机制之间的平衡。考虑到低密度脂蛋白胆固醇和炎症之间并非竞争关系,而是同谋关系,本综述旨在概述与低密度脂蛋白胆固醇浓度升高相关的主要炎症分子途径,并描述降脂方法对炎症和脂质负担的影响。尽管最新的降脂组合推动了低密度脂蛋白胆固醇的显著变化,但血浆C反应蛋白的相对降低似乎与低密度脂蛋白胆固醇的降低幅度无关:结论:确定炎症的临床生物标志物(如白细胞介素-6)和可能的治疗靶点,为监测和减轻合适患者的 ASCVD 负担带来了希望。
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来源期刊
CiteScore
9.50
自引率
3.60%
发文量
192
审稿时长
1 months
期刊介绍: EJCI considers any original contribution from the most sophisticated basic molecular sciences to applied clinical and translational research and evidence-based medicine across a broad range of subspecialties. The EJCI publishes reports of high-quality research that pertain to the genetic, molecular, cellular, or physiological basis of human biology and disease, as well as research that addresses prevalence, diagnosis, course, treatment, and prevention of disease. We are primarily interested in studies directly pertinent to humans, but submission of robust in vitro and animal work is also encouraged. Interdisciplinary work and research using innovative methods and combinations of laboratory, clinical, and epidemiological methodologies and techniques is of great interest to the journal. Several categories of manuscripts (for detailed description see below) are considered: editorials, original articles (also including randomized clinical trials, systematic reviews and meta-analyses), reviews (narrative reviews), opinion articles (including debates, perspectives and commentaries); and letters to the Editor.
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