斑块血管生成及其与炎症和动脉粥样硬化斑块不稳定的关系。
Plaque angiogenesis and its relation to inflammation and atherosclerotic plaque destabilization.
作者信息
de Vries Margreet R, Quax Paul H A
机构信息
Department of Surgery, Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.
出版信息
Curr Opin Lipidol. 2016 Oct;27(5):499-506. doi: 10.1097/MOL.0000000000000339.
PURPOSE OF REVIEW
The review discusses the recent literature on plaque angiogenesis and its relation to inflammation and plaque destabilization. Furthermore, it discusses how plaque angiogenesis can be used to monitor atherosclerosis and serve as a therapeutic target.
RECENT FINDINGS
Histopathologic studies have shown a clear relationship between plaque angiogenesis, intraplaque hemorrhage (IPH), plaque vulnerability, and cardiovascular events. Hypoxia is a main driver of plaque angiogenesis and the mechanism behind angiogenesis is only partly known. IPH, as the result of immature neovessels, is associated with increased influx of inflammatory cells in the plaques. Experimental models displaying certain features of human atherosclerosis such as plaque angiogenesis or IPH are developed and can contribute to unraveling the mechanism behind plaque vulnerability. New imaging techniques are established, with which plaque angiogenesis and vulnerability can be detected. Furthermore, antiangiogenic therapies in atherosclerosis gain much attention.
SUMMARY
Plaque angiogenesis, IPH, and inflammation contribute to plaque vulnerability. Histopathologic and imaging studies together with specific experimental studies have provided insights in plaque angiogenesis and plaque vulnerability. However, more extensive knowledge on the underlying mechanism is required for establishing new therapies for patients at risk.
综述目的
本综述讨论了近期关于斑块血管生成及其与炎症和斑块不稳定关系的文献。此外,还讨论了斑块血管生成如何用于监测动脉粥样硬化并作为治疗靶点。
近期研究发现
组织病理学研究表明,斑块血管生成、斑块内出血(IPH)、斑块易损性和心血管事件之间存在明确关系。缺氧是斑块血管生成的主要驱动因素,血管生成背后的机制仅部分为人所知。由于新生血管不成熟导致的IPH与斑块内炎症细胞流入增加有关。已开发出显示人类动脉粥样硬化某些特征(如斑块血管生成或IPH)的实验模型,这有助于阐明斑块易损性背后的机制。新的成像技术已建立,可用于检测斑块血管生成和易损性。此外,动脉粥样硬化的抗血管生成疗法备受关注。
总结
斑块血管生成、IPH和炎症导致斑块易损性。组织病理学和影像学研究以及特定的实验研究为斑块血管生成和斑块易损性提供了见解。然而,为有风险的患者建立新疗法需要对潜在机制有更广泛的了解。