Poredos Pavel, Jezovnik Mateja K
Department of Vascular Disease, University Medical Centre Ljubljana, Zaloska cesta 7, 1000 Ljubljana, Slovenia..
Curr Vasc Pharmacol. 2016;14(6):534-546. doi: 10.2174/1570161114666160625080104.
The estimation of risk for atherosclerotic cardiovascular (CV) events based only on the presence of classical risk factors is often insufficient. Therefore, efforts have been made to find markers that indicate the presence of preclinical or clinical disease. Inflammation mediates all stages of the disease, from initiation to the thrombotic complications of atherosclerosis. Raised levels of several circulating markers, particularly inflammatory mediators, have been reported in subjects with atherosclerosis. Increased risk for CV events is associated with increased levels of cytokines, celladhesion molecules, P-selectin and E-selectin, and acute phase reactants, such a highsensitivity C-reactive protein and serum amyloid-A. Elevation of some of these markers predicts the outcomes of patients with acute coronary syndromes. However, because of their non-specificity, these biomarkers represent only a moderate added predicting value after considering conventional CV risk factors. Consequently, recent research has focused on the detection of vulnerable plaque, using vascular bed-specific biomarkers that can help identify individuals at highest risk and help guide how to intervene to prevent CV events. Considerable progress in the understanding of the role of the inflammation in atherogenesis has opened new possibilities for the management of atherosclerosis. Recently new drugs mediating the direct inhibition of circulating markers of inflammation were developed. These drugs could provide a novel therapeutic approach and further enhance the understanding of the role of inflammation in atherosclerosis.
仅基于经典危险因素的存在来估计动脉粥样硬化性心血管（CV）事件的风险往往是不够的。因此，人们一直在努力寻找能够指示临床前或临床疾病存在的标志物。炎症介导了该疾病从起始到动脉粥样硬化血栓形成并发症的各个阶段。在患有动脉粥样硬化的受试者中，已报告多种循环标志物水平升高，尤其是炎症介质。CV事件风险增加与细胞因子、细胞黏附分子、P选择素和E选择素以及急性期反应物（如高敏C反应蛋白和血清淀粉样蛋白A）水平升高有关。这些标志物中的一些升高可预测急性冠状动脉综合征患者的预后。然而，由于它们的非特异性，在考虑传统CV危险因素后，这些生物标志物仅具有中等程度的额外预测价值。因此，最近的研究集中在使用血管床特异性生物标志物检测易损斑块，这些生物标志物有助于识别风险最高的个体，并指导如何进行干预以预防CV事件。在理解炎症在动脉粥样硬化发生中的作用方面取得了相当大的进展，为动脉粥样硬化的管理开辟了新的可能性。最近开发了介导直接抑制循环炎症标志物的新药。这些药物可以提供一种新的治疗方法，并进一步加深对炎症在动脉粥样硬化中作用的理解。
