Husain Kazim, Hernandez Wilfredo, Ansari Rais A, Ferder Leon
Kazim Husain, Leon Ferder, Department of Physiology, Pharmacology and Toxicology, Ponce School of Medicine, Ponce, PR 00732, United States.
World J Biol Chem. 2015 Aug 26;6(3):209-17. doi: 10.4331/wjbc.v6.i3.209.
Atherosclerosis is a chronic inflammatory disease associated with cardiovascular dysfunction including myocardial infarction, unstable angina, sudden cardiac death, stroke and peripheral thromboses. It has been predicted that atherosclerosis will be the primary cause of death in the world by 2020. Atherogenesis is initiated by endothelial injury due to oxidative stress associated with cardiovascular risk factors including diabetes mellitus, hypertension, cigarette smoking, dyslipidemia, obesity, and metabolic syndrome. The impairment of the endothelium associated with cardiovascular risk factors creates an imbalance between vasodilating and vasoconstricting factors, in particular, an increase in angiotensin II (Ang II) and a decrease in nitric oxide. The renin-angiotensin system (RAS), and its primary mediator Ang II, also have a direct influence on the progression of the atherosclerotic process via effects on endothelial function, inflammation, fibrinolytic balance, and plaque stability. Anti-inflammatory agents [statins, secretory phospholipase A2 inhibitor, lipoprotein-associated phospholipase A2 inhibitor, 5-lipoxygenase activating protein, chemokine motif ligand-2, C-C chemokine motif receptor 2 pathway inhibitors, methotrexate, IL-1 pathway inhibitor and RAS inhibitors (angiotensin-converting enzyme inhibitors)], Ang II receptor blockers and ranin inhibitors may slow inflammatory processes and disease progression. Several studies in human using anti-inflammatory agents and RAS inhibitors revealed vascular benefits and reduced progression of coronary atherosclerosis in patients with stable angina pectoris; decreased vascular inflammatory markers, improved common carotid intima-media thickness and plaque volume in patients with diagnosed atherosclerosis. Recent preclinical studies have demonstrated therapeutic efficacy of vitamin D analogs paricalcitol in ApoE-deficient atherosclerotic mice.
动脉粥样硬化是一种慢性炎症性疾病,与心血管功能障碍相关,包括心肌梗死、不稳定型心绞痛、心源性猝死、中风和外周血栓形成。据预测,到2020年动脉粥样硬化将成为全球主要死因。动脉粥样硬化的发生始于内皮损伤,这种损伤是由与心血管危险因素相关的氧化应激引起的,这些危险因素包括糖尿病、高血压、吸烟、血脂异常、肥胖和代谢综合征。与心血管危险因素相关的内皮功能损害导致血管舒张和收缩因子之间失衡,特别是血管紧张素II(Ang II)增加和一氧化氮减少。肾素-血管紧张素系统(RAS)及其主要介质Ang II也通过对内皮功能、炎症、纤维蛋白溶解平衡和斑块稳定性的影响,直接影响动脉粥样硬化进程的发展。抗炎药物[他汀类药物、分泌型磷脂酶A2抑制剂、脂蛋白相关磷脂酶A2抑制剂、5-脂氧合酶激活蛋白、趋化因子基序配体-2、C-C趋化因子基序受体2途径抑制剂、甲氨蝶呤、IL-1途径抑制剂和RAS抑制剂(血管紧张素转换酶抑制剂)]、Ang II受体阻滞剂和肾素抑制剂可能会减缓炎症过程和疾病进展。几项针对人类使用抗炎药物和RAS抑制剂的研究表明,对于稳定型心绞痛患者,这些药物具有血管益处并减缓了冠状动脉粥样硬化的进展;对于已确诊动脉粥样硬化的患者,这些药物降低了血管炎症标志物水平,改善了颈总动脉内膜中层厚度和斑块体积。最近的临床前研究已证明维生素D类似物帕立骨化醇对载脂蛋白E缺陷型动脉粥样硬化小鼠具有治疗效果。