Division of Cardiovascular Medicine, Department of Medicine, University of Cambridge, Cambridge, UK.
INSERM U970, Paris Cardiovascular Research Center, Paris, France, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Br J Pharmacol. 2017 Nov;174(22):3926-3939. doi: 10.1111/bph.13700. Epub 2017 Feb 1.
Cardiovascular diseases remain a major global health issue, with the development of atherosclerosis as a major underlying cause. Our treatment of cardiovascular disease has improved greatly over the past three decades, but much remains to be done reduce disease burden. Current priorities include reducing atherosclerosis advancement to clinically significant stages and preventing plaque rupture or erosion. Inflammation and involvement of the adaptive immune system influences all these aspects and therefore is one focus for future therapeutic development. The atherosclerotic vascular wall is now recognized to be invaded from both sides (arterial lumen and adventitia), for better or worse, by the adaptive immune system. Atherosclerosis is also affected at several stages by adaptive immune responses, overall providing many opportunities to target these responses and to reduce disease progression. Protective influences that may be defective in diseased individuals include humoral responses to modified LDL and regulatory T cell responses. There are many strategies in development to boost these pathways in humans, including vaccine-based therapies. The effects of various existing adaptive immune targeting therapies, such as blocking critical co-stimulatory pathways or B cell depletion, on cardiovascular disease are beginning to emerge with important consequences for both autoimmune disease patients and the potential for wider use of such therapies. Entering the translation phase for adaptive immune targeting therapies is an exciting and promising prospect.
This article is part of a themed section on Targeting Inflammation to Reduce Cardiovascular Disease Risk. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.22/issuetoc and http://onlinelibrary.wiley.com/doi/10.1111/bcp.v82.4/issuetoc.
心血管疾病仍然是一个主要的全球健康问题，动脉粥样硬化的发展是一个主要的潜在原因。在过去的三十年中，我们对心血管疾病的治疗有了很大的改善，但仍有很多工作要做，以减轻疾病负担。目前的重点包括减少动脉粥样硬化进展到临床显著阶段，预防斑块破裂或侵蚀。炎症和适应性免疫系统的参与影响到所有这些方面，因此是未来治疗发展的一个重点。现在人们认识到，适应性免疫系统从两侧（动脉腔和血管外膜）侵入动脉粥样硬化血管壁，无论是好是坏。动脉粥样硬化在几个阶段也受到适应性免疫反应的影响，总的来说，为靶向这些反应和减少疾病进展提供了许多机会。在患病个体中可能存在缺陷的保护作用包括对修饰的 LDL 的体液反应和调节性 T 细胞反应。目前有许多策略正在开发中，以在人类中增强这些途径，包括基于疫苗的治疗。各种现有的适应性免疫靶向治疗的效果，如阻断关键共刺激途径或 B 细胞耗竭，对心血管疾病的影响开始显现，对自身免疫性疾病患者和广泛应用此类治疗的潜力都有重要影响。进入适应性免疫靶向治疗的翻译阶段是一个令人兴奋和有前途的前景。
本文是靶向炎症以降低心血管疾病风险的专题的一部分。要查看本部分中的其他文章，请访问 http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.22/issuetoc 和 http://onlinelibrary.wiley.com/doi/10.1111/bcp.v82.4/issuetoc。
