Dept. of General Internal Medicine, Endocrinology and Metabolic Diseases, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, The Netherlands.
Atherosclerosis. 2013 Jun;228(2):306-15. doi: 10.1016/j.atherosclerosis.2013.02.028. Epub 2013 Mar 1.
Dyslipidemia and inflammation are well known causal risk factors the development of atherosclerosis. The interplay between lipid metabolism and inflammation at multiple levels in metabolic active tissues may exacerbate the development of atherosclerosis, and will be discussed in this review. Cholesterol, fatty acids and modified lipids can directly activate inflammatory pathways. In addition, circulating (modified) lipoproteins modulate the activity of leukocytes. Vice versa, proinflammatory signaling (i.e. cytokines) in pre-clinical models directly affects lipid metabolism. Whereas the main lipid-lowering drugs all have potent anti-inflammatory actions, the lipid-modulating actions of anti-inflammatory agents appear to be less straightforward. The latter have mainly been evaluated in pre-clinical models and in patients with chronic inflammatory diseases, which will be discussed. The clinical trials that are currently conducted to evaluate the efficacy of anti-inflammatory agents in the treatment of cardiovascular diseases may additionally reveal potential (beneficial) effects of these therapeutics on lipid metabolism in the general population at risk for CVD.
血脂异常和炎症是众所周知的动脉粥样硬化发展的因果风险因素。在代谢活跃组织的多个水平上，脂质代谢和炎症之间的相互作用可能会加剧动脉粥样硬化的发展，这将在本综述中进行讨论。胆固醇、脂肪酸和修饰脂质可以直接激活炎症途径。此外，循环（修饰）脂蛋白调节白细胞的活性。相反，临床前模型中的促炎信号（即细胞因子）直接影响脂质代谢。虽然主要的降脂药物都具有很强的抗炎作用，但抗炎药物的脂质调节作用似乎不那么直接。后者主要在临床前模型和患有慢性炎症性疾病的患者中进行了评估，这将在讨论中进行。目前正在进行的评估抗炎药物在心血管疾病治疗中的疗效的临床试验，可能会进一步揭示这些治疗方法对心血管疾病风险人群脂质代谢的潜在（有益）影响。
