Fisman Enrique Z, Motro Michael, Tenenbaum Alexander
Cardiac Rehabilitation Institute, Sheba Medical Center, 52621 Tel-Hashomer, Israel.
Cardiovasc Diabetol. 2003 Sep 12;2:11. doi: 10.1186/1475-2840-2-11.
The impressive correlation between cardiovascular disease and glucose metabolism alterations has raised the likelihood that atherosclerosis and type 2 diabetes may share common antecedents. Inflammation is emerging as a conceivable etiologic mechanism for both. Interleukins are regulatory proteins with ability to accelerate or inhibit inflammatory processes.
A novel interleukins classification is described, based on their role in diabetes and atherosclerosis, hypothesizing that each interleukin (IL) acts on both diseases in the same direction--regardless if harmful, favorable or neutral.
The 29 known interleukins were clustered into three groups: noxious (the "bad", 8 members), comprising IL-1, IL-2, IL-6, IL-7, IL-8, IL-15, IL-17 and IL-18; protective (the "good", 5 members), comprising IL-4, IL-10, IL-11, IL-12 and IL-13; and "aloof", comprising IL-5, IL-9, IL-14, IL-16 and IL-19 through IL-29 (15 members). Each group presented converging effects on both diseases. IL-3 was reluctant to clustering.
These observations imply that 1) favorable effects of a given IL on either diabetes or atherosclerosis predicts similar effects on the other; 2) equally, harmful IL effects on one disease can be extrapolated to the other; and 3) absence of influence of a given IL on one of these diseases forecasts lack of effects on the other. These facts further support the unifying etiologic theory of both ailments, emphasizing the importance of a cardiovascular diabetologic approach to interleukins for future research. Pharmacologic targeting of these cytokines might provide an effective means to simultaneously control both atherosclerosis and diabetes.
心血管疾病与葡萄糖代谢改变之间令人瞩目的相关性增加了动脉粥样硬化和2型糖尿病可能有共同前驱因素的可能性。炎症正成为这两种疾病可能的病因机制。白细胞介素是具有加速或抑制炎症过程能力的调节蛋白。
基于白细胞介素在糖尿病和动脉粥样硬化中的作用，描述了一种新的白细胞介素分类，假设每种白细胞介素（IL）对这两种疾病的作用方向相同——无论其是有害、有益还是中性。
将29种已知的白细胞介素分为三组：有害组（“坏”组，8个成员），包括IL-1、IL-2、IL-6、IL-7、IL-8、IL-15、IL-17和IL-18；保护组（“好”组，5个成员），包括IL-4、IL-10、IL-11、IL-12和IL-13；以及“无关组”，包括IL-5、IL-9、IL-14、IL-16和IL-19至IL-29（15个成员）。每组对这两种疾病都有趋同作用。IL-3难以归类。
这些观察结果表明：1）特定白细胞介素对糖尿病或动脉粥样硬化的有益作用预示着对另一种疾病有类似作用；2）同样，白细胞介素对一种疾病的有害作用也可推断至另一种疾病；3）特定白细胞介素对其中一种疾病无影响预示着对另一种疾病也无影响。这些事实进一步支持了这两种疾病的统一病因理论，强调了心血管糖尿病学方法对白细胞介素未来研究的重要性。对这些细胞因子进行药物靶向治疗可能提供一种同时控制动脉粥样硬化和糖尿病的有效手段。
