Huet Fabien, Akodad Mariama, Fauconnier Jérémy, Lacampagne Alain, Roubille François
a Cardiology Department, Hôpital Arnaud de Villeneuve, CHU de Montpellier, UFR de Médecine , Université Montpellier 1 , Montpellier cedex , France.
b PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214 , Montpellier cedex , France.
Expert Rev Cardiovasc Ther. 2017 Feb;15(2):109-125. doi: 10.1080/14779072.2017.1273771. Epub 2016 Dec 28.
Inflammation is a well-known powerful effector of atherosclerosis development. Cell infiltration induces inflammatory signal increasing plaque formation as well as its destabilization, leading to cardiovascular disease including myocardial infarction. During ischemia, necrotic cardiomyocytes stimulate the inflammatory storm into the myocardium (by chemokines, vascular adhesion molecules, interleukins action) promoting cardiac repair but also remodeling. Areas covered: Herein the authors present each condition (atherosclerosis and myocardial infarction) in two separate parts. Pathophysiology is briefly presented and focused on its implication in inflammation. Non-invasive techniques are presented, which explore inflammation in vivo. Several anti-inflammatory drugs are presented (mechanism of action, already published studies and ongoing trials are summarized). Expert commentary: Whereas atherosclerosis, regarding both the step-by-step pathophysiology and the acute plaque destabilization, is widely recognized as involving inflammatory pathways, the current translations in clinical practice remain poor. However, both basic and clinical research are active in the field, and the first large trials should soon be available, corroborating or not whether modulating inflammatory processes could be of interest in clinical practice.
炎症是动脉粥样硬化发展过程中一种众所周知的强大效应器。细胞浸润会诱导炎症信号，增加斑块形成及其不稳定性，从而导致包括心肌梗死在内的心血管疾病。在缺血期间，坏死的心肌细胞会刺激炎症风暴进入心肌（通过趋化因子、血管粘附分子、白细胞介素的作用），促进心脏修复但也会导致重塑。涵盖领域：在此，作者在两个单独部分分别介绍了每种情况（动脉粥样硬化和心肌梗死）。简要介绍了病理生理学，并重点阐述了其在炎症中的影响。介绍了探索体内炎症的非侵入性技术。介绍了几种抗炎药物（总结了其作用机制、已发表的研究和正在进行的试验）。专家评论：虽然动脉粥样硬化，无论是逐步的病理生理学还是急性斑块不稳定，都被广泛认为涉及炎症途径，但目前在临床实践中的转化效果仍然不佳。然而，该领域的基础研究和临床研究都很活跃，首批大型试验应该很快就会出现，证实或否定调节炎症过程在临床实践中是否有意义。
