Атеросклероз и воспаление: современные терапевтические стратегии

Обложка

Цитировать

Полный текст

Аннотация

Атеросклероз – это хроническое заболевание, являющееся основной причиной сердечно-сосудистых патологий. Воспаление – один из ключевых факторов в патогенезе атеросклероза и его осложнений. В обзоре приведены современные представления об иммунологических механизмах атерогенеза и биомаркерах воспаления, представлены доступные методы лечения хронического воспаления низкой интенсивности, а также информация об изучаемых перспективных направлениях фармакологической противовоспалительной терапии при атеросклерозе.

Об авторах

Марина Юрьевна Зубарева

ФГБУ «Национальный медицинский исследовательский центр кардиологии им. акад. Е.И. Чазова» Минздрава России

Email: igorcardio@mail.ru
ORCID iD: 0000-0002-2980-9167

канд. мед. наук, ст. науч. сотр. лаб. клинической липидологии отд. проблем атеросклероза, врач-кардиолог, липидолог 

Россия, Москва

Игорь Владимирович Сергиенко

ФГБУ «Национальный медицинский исследовательский центр кардиологии им. акад. Е.И. Чазова» Минздрава России

Автор, ответственный за переписку.
Email: igorcardio@mail.ru
ORCID iD: 0000-0003-1534-3965

д-р мед. наук, проф., гл. науч. сотр., рук. лаб. фенотипов атеросклероза

Россия, Москва

Список литературы

  1. Murray CJL, Afshin A, Alam T, et al. Global Burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990–2019: A Systematic Analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204-22. doi: 10.1016/S0140-6736(20)30752-2
  2. Vaduganathan M, Mensah GA, Turco JV, et al. The Global Burden of Cardiovascular Diseases and Risk: A Compass for Future Health. J Am Coll Cardiol. 2022;80:2361-71. doi: 10.1016/j.jacc.2022.11.005
  3. Libby P. Inflammation in Atherosclerosis. Arterioscler Thromb Vasc Biol. 2012;32:2045-51. doi: 10.1161/ATVBAHA.108.179705
  4. Hansson GK. Inflammation, Atherosclerosis, and Coronary Artery Disease. N Engl J Med. 2005;352:1685-95. doi: 10.1056/NEJMra043430
  5. Бойцов С.А., Погосова Н.В., Аншелес А.А., и др. Кардиоваскулярная профилактика 2022. Российские национальные рекомендации. Российский кардиологический журнал. 2023;28(5):5452 [Boytsov SA, Pogosova NV, Ansheles AA, et al. Cardiovascular prevention 2022. Russian national guidelines. Russian Journal of Cardiology. 2023;28(5):5452 (in Russian)]. doi: 10.15829/1560-4071-2023-5452
  6. Agca R, Smulders Y, Nurmohamed M. Cardiovascular Disease Risk in Immune-Mediated Inflammatory Diseases: Recommendations for Clinical Practice. Heart. 2022;108:73-9. doi: 10.1136/heartjnl-2019-316378
  7. Agca R, Heslinga SC, Rollefstad S, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Ann Rheum Dis. 2017;76(1):17-28. doi: 10.1136/annrheumdis-2016-209775
  8. Attiq A, Afzal S, Ahmad W, Kandeel M. Hegemony of inflammation in atherosclerosis and coronary artery disease. Eur J Pharmacol. 2024;966:176338. doi: 10.1016/j.ejphar.2024.176338
  9. Badimon L, Padró T, Vilahur G. Atherosclerosis, Platelets and Thrombosis in Acute Ischaemic Heart Disease. Eur Heart J Acute Cardiovasc Care. 2012;1:60-74. doi: 10.1177/2048872612441582
  10. Laera N, Malerba P, Vacanti G, et al. Impact of Immunity on Coronary Artery Disease: An Updated Pathogenic Interplay and Potential Therapeutic Strategies. Life (Basel). 2023;13(11):2128. doi: 10.3390/life13112128
  11. Zhang H, Dhalla NS. The Role of Pro-Inflammatory Cytokines in the Pathogenesis of Cardiovascular Disease. Int J Mol Sci. 2024;25(2):1082. doi: 10.3390/ijms25021082
  12. Liu W, Yin Y, Zhou Z, et al. OxLDL-induced IL-1 beta secretion promoting foam cells formation was mainly via CD36 mediated ROS production leading to NLRP3 inflammasome activation. Inflamm Res. 2014;63(1):33-43. doi: 10.1007/s00011-013-0667-3
  13. Waksman R, Merdler I, Case BC, et al. Targeting inflammation in atherosclerosis: overview, strategy and directions. EuroIntervention. 2024;20(1):32-44. doi: 10.4244/EIJ-D-23-00606
  14. Kaptoge S, Di Angelantonio E, Lowe G, et al. C-Reactive Protein Concentration and Risk of Coronary Heart Disease, Stroke, and Mortality: An Individual Participant Meta-Analysis. Lancet. 2010;375:132-40. doi: 10.1016/S0140-6736(09)61717-7
  15. Yang X, Zhang D, Zhao Y, et al. Association between serum level of C-reactive protein and risk of cardiovascular events based on cohort studies. J Hum Hypertens. 2021;35(12):1149-58. doi: 10.1038/s41371-021-00546-z
  16. Emerging Risk Factors Collaboration; Kaptoge S, Di Angelantonio E, Lowe G, et al. C-reactive protein concentration and risk of coronary heart disease, stroke, and mortality: an individual participant meta-analysis. Lancet. 2010;375(9709):132-40. doi: 10.1016/S0140-6736(09)61717-7
  17. Liu H-H, Cao Y-X, Sun D, et al. High-sensitivity C-reactive protein and hypertension: combined effects on coronary severity and cardiovascular outcomes. Hypertens Res. 2019;42(11):1783-93. doi: 10.1038/s41440-019-0293-8
  18. Oemrawsingh RM, Cheng JM, Akkerhuis KM, et al. High-sensitivity C-reactive protein predicts 10-year cardiovascular outcome after percutaneous coronary intervention. EuroIntervention. 2016;12(3):345-51. doi: 10.4244/EIJY15M07_04
  19. Carrero JJ, Andersson Franko M, Obergfell A, et al. hsCRP Level and the Risk of Death or Recurrent Cardiovascular Events in Patients With Myocardial Infarction: a Healthcare-Based Study. J Am Heart Assoc. 2019;8(11):e012638. doi: 10.1161/JAHA.119.012638
  20. Quispe R, Michos ED, Martin SS, et al. High-Sensitivity C-Reactive Protein Discordance With Atherogenic Lipid Measures and Incidence of Atherosclerotic Cardiovascular Disease in Primary Prevention: The ARIC Study. J Am Heart Assoc. 2020;9:e013600.
  21. Ridker PM, Bhatt DL, Pradhan AD, et al; PROMINENT, REDUCE-IT, and STRENGTH Investigators. Inflammation and cholesterol as predictors of cardiovascular events among patients receiving statin therapy: a collaborative analysis of three randomised trials. Lancet. 2023;401:1293-301.
  22. Walter J, Tanglay Y, du Fay de Lavallaz J, et al. Clinical utility of circulating interleukin-6 concentrations in the detection of functionally relevant coronary artery disease. Int J Cardiol. 2019;275:20-5.
  23. Yang C, Deng Z, Li J, et al. Meta-analysis of the relationship between interleukin-6 levels and the prognosis and severity of acute coronary syndrome. Clinics (Sao Paulo). 2021;76:e2690. doi: 10.6061/clinics/2021/e2690
  24. Okazaki S, Sakaguchi M, Miwa K, et al. Association of Interleukin-6 With the Progression of Carotid Atherosclerosis A 9-Year Follow-Up Study. Stroke. 2014;45:29242929.
  25. Held C, White HD, Stewart RAH, et al; STABILITY Investigators. Inflammatory Biomarkers Interleukin-6 and C-Reactive Protein and Outcomes in Stable Coronary Heart Disease: Experiences From the STABILITY (Stabilization of Atherosclerotic Plaque by Initiation of Darapladib Therapy) Trial. J Am Heart Assoc. 2017;6(10):e005077. doi: 10.1161/JAHA.116.005077
  26. Interleukin-6 Receptor Mendelian Randomisation Analysis (IL6R MR) Consortium; Swerdlow DI, Holmes MV, Kuchenbaecker KB, et al. The interleukin-6 receptor as a target for prevention of coronary heart disease: a mendelian randomisation analysis. Lancet. 2012;379(9822):1214-24. doi: 10.1016/S0140-6736(12)60110-X
  27. Zhao L, Ma D, Wang L, et al. Metabolic changes with the occurrence of atherosclerotic plaques and the effects of statins. Front Immunol. 2023;14:1301051. doi: 10.3389/fimmu.2023.1301051
  28. Liberale L, Carbone F, Montecucco F, Sahebkar A. Statins reduce vascular inflammation in atherogenesis: A review of underlying molecular mechanisms. Int J Biochem Cell Biol. 2020;122:105735. doi: 10.1016/j.biocel.2020.105735
  29. Jain MK, Ridker PM. Anti-Inflammatory Effects of Statins: Clinical Evidence and Basic Mechanisms. Nat Rev Drug Discov. 2005;4:977-87. doi: 10.1038/nrd1901
  30. Koushki K, Shahbaz SK, Mashayekhi K, et al. Anti-inflammatory Action of Statins in Cardiovascular Disease: the Role of Inflammasome and Toll-Like Receptor Pathways. Clin Rev Allergy Immunol. 2021;60(2):175-99. doi: 10.1007/s12016-020-08791-9
  31. Semb AG, Kvien TK, DeMicco DA, et al. Effect of intensive lipid-lowering therapy on cardiovascular outcome in patients with and those without inflammatory joint disease. Arthritis Rheum. 2012;64(9):2836-46. doi: 10.1002/art.34524
  32. De Vera MA, Choi H, Abrahamowicz M, et al. Statin discontinuation and risk of acute myocardial infarction in patients with rheumatoid arthritis: a population-based cohort study. Ann Rheum Dis. 2011;70(6):1020-4. doi: 10.1136/ard.2010.142455
  33. Corsini A, Bellosta S, Baetta R, et al. New insights into the pharmacodynamic and pharmacokinetic properties of statins. Pharmacol Ther. 1999;84(3):413-28. doi: 10.1016/s0163-7258(99)00045-5
  34. Bonsu KO, Reidpath DD, Kadirvelu A. Effects of Statin Treatment on Inflammation and Cardiac Function in Heart Failure: An Adjusted Indirect Comparison Meta-Analysis of Randomized Trials. Cardiovasc Ther. 2015;33(6):338-46. doi: 10.1111/1755-5922.12150
  35. Bonsu KO, Reidpath DD, Kadirvelu A. Lipophilic Statin Versus Rosuvastatin (Hydrophilic) Treatment for Heart Failure: a Meta-Analysis and Adjusted Indirect Comparison of Randomised Trials. Cardiovasc Drugs Ther. 2016;30(2):177-88. doi: 10.1007/s10557-015-6636-z
  36. Кухарчук В.В., Ежов М.В., Сергиенко И.В., и др. Клинические рекомендации Евразийской ассоциации кардиологов (ЕАК) / Национального общества по изучению атеросклероза (НОА) по диагностике и коррекции нарушений липидного обмена с целью профилактики и лечения атеросклероза (2020). Евразийский кардиологический журнал. 2020;(2):6-29 [Kukharchuk VV, Ezhov MV, Sergienko IV, et al. Eurasian Association oF Cardiology (EAC) / Russian National Atherosclerosis Society (RNAS, RUSSIA) Guidelines for the diagnosis and correction of dyslipidemia for the prevention and treatment of atherosclerosis. Eurasian Heart Journal. 2020;(2):6-29 (in Russian)]. doi: 10.38109/2225-1685-2020-2-6-29
  37. Bonnet J, McPherson R, Tedgui A, et al. CAP Investigators. Comparative effects of 10-mg versus 80-mg Atorvastatin on high-sensitivity C-reactive protein in patients with stable coronary artery disease: results of the CAP (Comparative AtorvastatinPleiotropic effects) study. Clin Ther. 2008;30(12):2298-313. doi: 10.1016/j.clinthera.2008.12.023
  38. Liu Z, Joerg H, Hao H, et al. Efficacy of High-Intensity Atorvastatin for Asian Patients Undergoing Percutaneous Coronary Intervention. Ann Pharmacother. 2016;50(9):725-33. doi: 10.1177/1060028016654722
  39. Liu Z, Xu Y, Hao H, et al. Efficacy of high intensity atorvastatin versus moderate intensity atorvastatin for acute coronary syndrome patients with diabetes mellitus. Int J Cardiol. 2016;222:22-6. doi: 10.1016/j.ijcard.2016.07.140
  40. Qu Y, Wei L, Zhang H. Inhibition of inflammation mediates the protective effect of atorvastatin reload in patients with coronary artery disease undergoing noncardiac emergency surgery. Coron Artery Dis. 2014;25(8):678-84. doi: 10.1097/MCA.0000000000000143
  41. Gavazzoni M, Gorga E, Derosa G, et al. High-dose atorvastatin versus moderate dose on early vascular protection after ST-elevation myocardial infarction. Drug Des Devel Ther. 2017;11:3425-34. doi: 10.2147/DDDT.S135173
  42. Komukai K, Kubo T, Kitabata H, et al. Effect of atorvastatin therapy on fibrous cap thickness in coronary atherosclerotic plaque as assessed by optical coherence tomography: the EASY-FIT study. J Am Coll Cardiol. 2014;64(21):2207-17. DOI:10.1016/j. jacc.2014.08.045
  43. Nicholls SJ, Ballantyne СМ, Barter PhJ, et al. Effect of two intensive statin regimens on progression of coronary disease. N Engl J Med. 2011;365:2078-87. doi: 10.1056/NEJMoa1110874
  44. Ridker PM, Morrow DA, Rose LM, et al. Relative efficacy of atorvastatin 80 mg and pravastatin 40 mg in achieving the dual goals of low-density lipoprotein cholesterol <70 mg/dl and C-reactive protein <2 mg/l: an analysis of the PROVE-IT TIMI-22 trial. J Am Coll Cardiol. 2005;45(10):1644-8. doi: 10.1016/j.jacc.2005.02.080
  45. Ridker PM, Everett BM, Thuren T, et al; Glynn RJ CANTOS Trial Group. Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease. N Engl J Med. 2017;377:1119-31.
  46. Abbate A, Trankle CR, Buckley LF, et al. Interleukin-1 Blockade Inhibits the Acute Inflammatory Response in Patients With ST-Segment-Elevation Myocardial Infarction. J Am Heart Assoc. 2020;9(5):e014941. doi: 10.1161/JAHA.119.014941
  47. Ridker PM, Devalaraja M, Baeres FMM, et al. IL-6 Inhibition with Ziltivekimab in Patients at High Atherosclerotic Risk (RESCUE): A Double-Blind, Randomised, Placebo-Controlled, Phase 2 Trial. Lancet. 2021;397:2060-9. doi: 10.1016/S0140-6736(21)00520-1
  48. Nidorf SM, Eikelboom JW, Budgeon CA, Thompson PL. Low-dose colchicine for secondary prevention of cardiovascular disease. J Am Coll Cardiol. 2013;61:404-10.
  49. Nidorf SM, Fiolet ATL, Mosterd A, et al; LoDoCo2 Trial Investigators. Colchicine in Patients with Chronic Coronary Disease. N Engl J Med. 2020;383(19):1838-47. doi: 10.1056/NEJMoa2021372
  50. Tardif JC, Kouz S, Waters DD, et al. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction. N Engl J Med. 2019;381(26):2497-505. doi: 10.1056/NEJMoa1912388

Дополнительные файлы

Доп. файлы
Действие
1. JATS XML
2. Рис. 1. Стадии развития АСБ (адаптировано из [8]).

Скачать (259KB)
3. Рис. 2. Стадии развития атеросклероза и связанные с ними воспалительные биомаркеры (адаптировано из [8]).

Скачать (224KB)

© ООО "Консилиум Медикум", 2024

Creative Commons License
Эта статья доступна по лицензии Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Данный сайт использует cookie-файлы

Продолжая использовать наш сайт, вы даете согласие на обработку файлов cookie, которые обеспечивают правильную работу сайта.

О куки-файлах