Targeting Inflammatory Pathways in Atherosclerosis: Exploring New Opportunities for Treatment.

IF 5.7 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Atherosclerosis Reports Pub Date : 2024-12-01 Epub Date: 2024-10-15 DOI:10.1007/s11883-024-01241-3

Alessia d'Aiello, Simone Filomia, Mattia Brecciaroli, Tommaso Sanna, Daniela Pedicino, Giovanna Liuzzo

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Abstract

Purpose of the review: This review discusses the molecular mechanisms involved in the immuno-pathogenesis of atherosclerosis, the pleiotropic anti-inflammatory effects of approved cardiovascular therapies and the available evidence on immunomodulatory therapies for atherosclerotic cardiovascular disease (ACVD). We highlight the importance of clinical and translational research in identifying molecular mechanisms and discovering new therapeutic targets.

Recent findings: The CANTOS (Canakinumab Anti-Inflammatory Thrombosis Outcomes Study) trial was the first to demonstrate a reduction in cardiovascular (CV) risk with anti-inflammatory therapy, irrespective of serum lipid levels. ACVD is the leading cause of death worldwide. Although targeting principal risk factors significantly reduces CV risk, residual risk remains unaddressed. The immunological mechanisms underlying atherosclerosis represent attractive therapeutic targets. Several commonly used and non-primarily anti-inflammatory drugs (i.e. SGLT2i, and PCSK9i) exhibit pleiotropic properties. Otherwise, recent trials have investigated the blockade of primarily inflammatory compounds, trying to lower the residual risk via low-dose IL-2, PTPN22 and CD31 pathway modulation. In the era of precision medicine, modern approaches may explore new pharmacological targets, identify new markers of vascular inflammation, and evaluate therapeutic responses.

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针对动脉粥样硬化的炎症通路：探索治疗新机遇。

综述的目的：这篇综述讨论了动脉粥样硬化免疫发病机制的分子机制、已获批准的心血管疗法的多重抗炎作用以及动脉粥样硬化性心血管疾病（ACVD）免疫调节疗法的现有证据。我们强调了临床和转化研究在确定分子机制和发现新治疗靶点方面的重要性：CANTOS（卡那库单抗抗炎血栓形成结果研究）试验首次证明，无论血清脂质水平如何，抗炎疗法都能降低心血管疾病（CV）风险。心血管疾病是导致全球死亡的主要原因。尽管针对主要风险因素的治疗能显著降低心血管疾病的风险，但残余风险仍未得到解决。动脉粥样硬化的免疫机制是极具吸引力的治疗目标。一些常用的非主要抗炎药物（如 SGLT2i 和 PCSK9i）具有多效应特性。此外，最近的试验还研究了主要阻断炎症化合物，试图通过低剂量 IL-2、PTPN22 和 CD31 通路调节来降低残余风险。在精准医疗时代，现代方法可以探索新的药理靶点，确定血管炎症的新标志物，并评估治疗反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Atherosclerosis Reports 医学-

CiteScore

9.00

自引率

3.40%

发文量

审稿时长

6-12 weeks

期刊介绍： The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.