Inflammatory mechanisms in atherosclerosis

 

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Summary

Throughout the last two decades inflammation has been recognized as the central mechanism underlying atherogenesis. A multitude of basic science work demonstrates the pivotal role of inflammatory processes during every step of atherosclerotic plaque formation: From initiation via propagation to complication.

This review describes some of the key mechanisms involved with a particular focus on the diverse group of inflammatory cells and their subsets that distinctly contribute to atherogenic and anti-atherogenic phenomena. Furthermore, we summarize the controlling action of a tight network of co-stimulatory molecules and cytokines orchestrating the inflammatory and anti-inflammatory effector functions. Finally, the current status of clinical trials evaluating anti-inflammatory/ immune-modulatory treatment strategies is summarized and an outlook for future therapeutic implications is provided.

Zusammenfassung

In den vergangenen zwei Dekaden wurde Inflammation als zentraler pathophysiologischer Mechanismus der Atherosklerose identifiziert. Eine Vielzahl grundlagenorientierter Arbeiten weist inflammatorischen Prozessen eine Schlüsselrolle bei jedem Schritt der atherosklerotischen Plaqueentstehung zu: von der Initiationsphase über die Propagationsphase bis zur Komplikationsphase der Erkrankung. Dieser Übersichtsartikel fasst die Schlüsselmechanismen zusammen mit einem dezidierten Fokus auf die vielseitige Gruppe inflammatorischer Zellen und deren Subtypen mit ihrem unterschiedlichen Beitrag zu atherogenen und antiatherogenen Prozessen. Darüber hinaus beschreiben wir das für die Koordination dieser Prozesse wichtige Zytokinnetzwerk. Abschließend wird der aktuelle Stand großer klinischer Studien zu antiinflammatorischen bzw. immunmodulatorischen Therapiestrategien zusammen gefasst, und ein Ausblick auf potenzielle künftige therapeutische Implikationen gegeben.

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