Interplay between hypercholesterolaemia and inflammation in atherosclerosis: Translating experimental targets into clinical practice
| Autor: | Tuñón, José, Bäck, Magnus, Badimón, Lina, Bochaton-Piallat, Marie-Luce, Cariou, Bertrand, Daemen, Mat J., Egido, Jesus, Evans, Paul C., Francis, Sheila E., Ketelhuth, Daniel Fj, Lutgens, Esther, Matter, Christian M., Monaco, Claudia, Steffens, Sabine, Stroes, Erik, Vindis, Cécile, Weber, Christian, Hoefer, Imo E., Atherosclerosis, ESC Working Group, Biology, Vascular |
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| Přispěvatelé: | Department of Cardiology, Karolinska University Hospital, Karolinska Institutet [Stockholm], Department of Medicine [Karolinska Institute], Karolinska University Hospital [Stockholm], Consejo Superior de Investigaciones Científicas [Madrid] (CSIC), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), ACS - Atherosclerosis & ischemic syndromes, Pathology, Medical Biochemistry, AII - Inflammatory diseases, Vascular Medicine, ACS - Heart failure & arrhythmias, Biochemie, RS: CARIM - R3.07 - Structure-function analysis of the chemokine interactome for therapeutic targeting and imaging in atherosclerosis |
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
STATIN THERAPY Epidemiology interleukin-1β [SDV]Life Sciences [q-bio] Anti-Inflammatory Agents ddc:616.07 030204 cardiovascular system & hematology Bioinformatics immune response law.invention Coronary artery disease 0302 clinical medicine Randomized controlled trial Risk Factors law Clinical Trials as Topic Evidence-Based Medicine biology Antibodies Monoclonal RANDOMIZED CONTROLLED-TRIAL Lipids C-REACTIVE PROTEIN 3. Good health Lipoproteins LDL FACTOR-KAPPA-B Treatment Outcome NATIONWIDE COHORT Rheumatoid arthritis CORONARY-ARTERY-DISEASE Inflammation Mediators medicine.symptom Cardiology and Cardiovascular Medicine medicine.drug Hypercholesterolemia Inflammation Antibodies Monoclonal Humanized canakinumab 03 medical and health sciences medicine Humans CARDIOVASCULAR EVENTS business.industry C-reactive protein medicine.disease SECONDARY ANALYSIS RHEUMATOID-ARTHRITIS Blockade Clinical trial Canakinumab 030104 developmental biology inflammation biology.protein MONOCLONAL-ANTIBODIES atherosclerosis business Biomarkers interleukin-1 |
| Zdroj: | European Journal of Preventive Cardiology European Journal of Preventive Cardiology, Sage Publications, 2018, Equipe IV, pp.2047487318773384. ⟨10.1177/2047487318773384⟩ European journal of preventive cardiology, 25(9), 948-955. SAGE Publications Ltd European Journal of Preventive Cardiology, 25(9), 948-955. SAGE Publications Ltd European Journal of Preventive Cardiology, Vol. 25, No 9 (2018) pp. 948-955 |
| ISSN: | 2047-4873 2047-4881 |
| DOI: | 10.1177/2047487318773384⟩ |
| Popis: | International audience; Dyslipidaemia and inflammation are closely interconnected in their contribution to atherosclerosis. In fact, low-density lipoprotein (LDL)-lowering drugs have anti-inflammatory effects. The Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) has shown that interleukin (IL)-1β blockade reduces the incidence of cardiovascular events in patients with previous myocardial infarction and C-reactive protein levels \textgreater2 mg/L. These data confirm the connection between lipids and inflammation, as lipids activate the Nod-like receptor protein 3 inflammasome that leads to IL-1β activation. LDL-lowering drugs are the foundation of cardiovascular prevention. Now, the CANTOS trial demonstrates that combining them with IL-1β blockade further decreases the incidence of cardiovascular events. However, both therapies are not at the same level, given the large evidence showing that LDL-lowering drugs reduce cardiovascular risk as opposed to only one randomized trial of IL-1β blockade. In addition, IL-1β blockade has only been studied in patients with C-reactive protein \textgreater2 mg/L, while the benefit of LDL-lowering is not restricted to these patients. Also, lipid-lowering drugs are not harmful even at very low ranges of LDL, while anti-inflammatory therapies may confer a higher risk of developing fatal infections and sepsis. In the future, more clinical trials are needed to explore whether targeting other inflammatory molecules, both related and unrelated to the IL-1β pathway, reduces the cardiovascular risk. In this regard, the ongoing trials with methotrexate and colchicine may clarify whether the cardiovascular benefit of IL-1β blockade extends to other anti-inflammatory mechanisms. A positive result would represent a major change in the future treatment of atherosclerosis. |
| Databáze: | OpenAIRE |
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