Girn H R S, Orsi N M, Homer-Vanniasinkam S
Leeds Vascular Institute, Leeds General Infirmary, Leeds, UK.
Vasc Med. 2007 Nov;12(4):299-309. doi: 10.1177/1358863X07083387.
Over the last three decades, a surge in research into the inflammatory pathophysiology of atherosclerosis has highlighted an array of cytokines and other inflammatory mediators associated with underlying inflammatory burden. The ability to identify and simultaneously measure multiple cytokines in peripheral blood highlights their potential as biomarkers of atherosclerosis. This has prompted much research in vascular medicine to identify the ;at-risk' groups for atherostenotic or atheroaneurysmal disease. This review is compiled with similar intentions and aims to discern the relevant evidence for cytokine profiling in peripheral arterial disease (PAD), where such information is lacking, while providing a holistic overview of cytokine interactions in atherosclerosis. This is pertinent given that cytokine profiles from coronary artery disease and aortic aneurysm studies cannot be directly extrapolated to PAD due to differences in inflammatory environments that exist in these conditions. Whilst plaque morphology and blood rheology play an important role in the cardiac manifestations of atherosclerosis, tissue thrombogenecity is very important in PAD. Further, cytokines act in concert rather than in isolation in a disease process, and no single cytokine in a cross-sectional model is able to serve as an absolute screening marker. Thus, it is essential to understand the regulation of cytokine production in atherosclerosis prior to evaluating the viability and merits of a multimarker approach for clinical risk stratification in PAD.
在过去三十年中，对动脉粥样硬化炎症病理生理学的研究热潮凸显了一系列与潜在炎症负担相关的细胞因子和其他炎症介质。在外周血中识别并同时测量多种细胞因子的能力突出了它们作为动脉粥样硬化生物标志物的潜力。这促使血管医学领域进行了大量研究，以确定动脉粥样硬化性狭窄或动脉瘤性疾病的“高危”人群。本综述怀着类似的意图编写，旨在辨别外周动脉疾病（PAD）中细胞因子谱分析的相关证据（目前此类信息尚缺），同时全面概述动脉粥样硬化中细胞因子的相互作用。鉴于冠状动脉疾病和主动脉瘤研究中的细胞因子谱因这些病症中存在的炎症环境差异而无法直接外推至PAD，这一点至关重要。虽然斑块形态和血液流变学在动脉粥样硬化的心脏表现中起重要作用，但组织血栓形成性在PAD中非常重要。此外，细胞因子在疾病过程中协同作用而非单独作用，横断面模型中的单一细胞因子都不能作为绝对的筛查标志物。因此，在评估多标志物方法用于PAD临床风险分层的可行性和优点之前，了解动脉粥样硬化中细胞因子产生调控至关重要。
