Carter Angela M
Academic Unit of Molecular Vascular Medicine, The LIGHT Laboratories, Clarendon Way, University of Leeds, Leeds LS2 9JT, UK.
Diab Vasc Dis Res. 2005 Oct;2(3):113-21. doi: 10.3132/dvdr.2005.018.
Inflammation plays a central role in the pathogenesis of acute coronary syndromes, the prevalence of which is increased in individuals with diabetes. Monocytes and macrophages, T cells and mast cells contribute to the initiation, development and rupture of atherosclerotic plaques by synthesising a variety of pro-inflammatory cytokines, including interleukin 1beta, interleukin 6 and tumour necrosis factor alpha. Cytokines upregulate endothelial cell adhesion molecules, recruit leukocytes and induce smooth muscle cell migration and proliferation. Cytokines act systemically to initiate the acute phase response, up-regulating proteins involved in inflammation and haemostasis and resulting in a pro-inflammatory and pro-thrombotic state. Expression of tissue factor by inflammatory cells potently induces thrombus formation upon plaque rupture, leading to acute coronary syndromes. Inflammatory biomarkers, including C-reactive protein, complement proteins, interleukin 6 and white blood cell count, predict development of acute coronary syndromes. C-reactive protein has been widely studied and consistently predicts future acute coronary syndrome events.
炎症在急性冠脉综合征的发病机制中起核心作用，糖尿病患者中急性冠脉综合征的患病率会升高。单核细胞与巨噬细胞、T细胞和肥大细胞通过合成多种促炎细胞因子（包括白细胞介素1β、白细胞介素6和肿瘤坏死因子α），促进动脉粥样硬化斑块的起始、发展和破裂。细胞因子上调内皮细胞黏附分子，募集白细胞，并诱导平滑肌细胞迁移和增殖。细胞因子通过全身作用引发急性期反应，上调参与炎症和止血的蛋白质，导致促炎和促血栓形成状态。炎症细胞表达的组织因子在斑块破裂时有力地诱导血栓形成，从而导致急性冠脉综合征。包括C反应蛋白、补体蛋白、白细胞介素6和白细胞计数在内的炎症生物标志物可预测急性冠脉综合征的发生。C反应蛋白已得到广泛研究，并且一直能够预测未来的急性冠脉综合征事件。
