von Hundelshausen P, Weber C
Institut für Prophylaxe und Epidemiologie der Kreislaufkrankheiten (IPEK), Klinikum der Universität München, Ludwig-Maximilians-Universität München und Deutsches Zentrum für Herz-Kreislaufforschung (DZHK), Partnerstandort Munich Heart Alliance.
Dtsch Med Wochenschr. 2013 Sep;138(37):1839-44. doi: 10.1055/s-0033-1349426. Epub 2013 Sep 4.
The increasing gain of knowledge regarding the mechanistic details of the pathogenesis of chronic inflammatory diseases e. g. of rheumatic origin, chronic viral infections and atherosclerosis have revealed in conjunction with detailed insights in acute inflammation interesting similarities and differences. Cytokines such as IL-1 and tumour necrosis factor-α are proximal components of inflammatory cascades of systemic mediators activating the endothelium which leads to an endothelial dysfunction and moreover alter the balance within lymphocytic subpopulations containing distinct arsenals of secretory mediators such as interferons, interleukins and chemokines. Proinflammatory lymphocyte subtypes are TH1 und TH17 cells whereas Treg and TH2 cells are anti-inflammatory opponents. Since several years, interleukin-1- and TNF-antagonists have expanded the spectrum of drugs against rheumatic diseases and are currently studied in the setting of cardiovascular prevention with positive results on surrogate parameters. On the other hand efforts are undertaken to test the hypothesis if the pleiotropic effects of statins may have a positive influence on rheumatoid arthritis.
关于慢性炎症性疾病（如风湿性疾病、慢性病毒感染和动脉粥样硬化）发病机制细节的知识不断增加，结合对急性炎症的详细了解，揭示了有趣的异同点。白细胞介素-1和肿瘤坏死因子-α等细胞因子是激活内皮细胞的全身介质炎症级联反应的近端成分，这会导致内皮功能障碍，进而改变淋巴细胞亚群之间的平衡，这些亚群含有不同的分泌介质库，如干扰素、白细胞介素和趋化因子。促炎淋巴细胞亚型是TH1和TH17细胞，而调节性T细胞和TH2细胞是抗炎对手。多年来，白细胞介素-1和肿瘤坏死因子拮抗剂拓宽了抗风湿疾病的药物谱，目前正在心血管预防领域进行研究，对替代指标有积极结果。另一方面，人们正在努力检验他汀类药物的多效性是否可能对类风湿性关节炎产生积极影响这一假设。
