Mozos Ioana, Malainer Clemens, Horbańczuk Jarosław, Gug Cristina, Stoian Dana, Luca Constantin Tudor, Atanasov Atanas G
Department of Functional Sciences, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
Center for Translational Research and Systems Medicine, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania.
Front Immunol. 2017 Aug 31;8:1058. doi: 10.3389/fimmu.2017.01058. eCollection 2017.
Arterial stiffness predicts an increased risk of cardiovascular events. Inflammation plays a major role in large arteries stiffening, related to atherosclerosis, arteriosclerosis, endothelial dysfunction, smooth muscle cell migration, vascular calcification, increased activity of metalloproteinases, extracellular matrix degradation, oxidative stress, elastolysis, and degradation of collagen. The present paper reviews main mechanisms explaining the crosstalk between inflammation and arterial stiffness and the most common inflammatory markers associated with increased arterial stiffness, considering the most recent clinical and experimental studies. Diverse studies revealed significant correlations between the severity of arterial stiffness and inflammatory markers, such as white blood cell count, neutrophil/lymphocyte ratio, adhesion molecules, fibrinogen, C-reactive protein, cytokines, microRNAs, and cyclooxygenase-2, in patients with a broad variety of diseases, such as metabolic syndrome, diabetes, coronary heart disease, peripheral arterial disease, malignant and rheumatic disorders, polycystic kidney disease, renal transplant, familial Mediterranean fever, and oral infections, and in women with preeclampsia or after menopause. There is strong evidence that inflammation plays an important and, at least, partly reversible role in the development of arterial stiffness, and inflammatory markers may be useful additional tools in the assessment of the cardiovascular risk in clinical practice. Combined assessment of arterial stiffness and inflammatory markers may improve non-invasive assessment of cardiovascular risk, enabling selection of high-risk patients for prophylactic treatment or more regular medical examination. Development of future destiffening therapies may target pro-inflammatory mechanisms.
动脉僵硬度可预测心血管事件风险增加。炎症在大动脉僵硬度增加过程中起主要作用,这与动脉粥样硬化、动脉硬化、内皮功能障碍、平滑肌细胞迁移、血管钙化、金属蛋白酶活性增加、细胞外基质降解、氧化应激、弹性蛋白溶解和胶原蛋白降解有关。本文结合最新的临床和实验研究,综述了解释炎症与动脉僵硬度之间相互作用的主要机制以及与动脉僵硬度增加相关的最常见炎症标志物。多项研究表明,在患有多种疾病的患者中,如代谢综合征、糖尿病、冠心病、外周动脉疾病、恶性和风湿性疾病、多囊肾病、肾移植、家族性地中海热和口腔感染,以及患有先兆子痫的女性或绝经后的女性中,动脉僵硬度的严重程度与炎症标志物之间存在显著相关性,这些炎症标志物包括白细胞计数、中性粒细胞/淋巴细胞比值、黏附分子、纤维蛋白原、C反应蛋白、细胞因子、微小RNA和环氧化酶-2。有强有力的证据表明,炎症在动脉僵硬度的发展中起重要作用,且至少部分是可逆的,炎症标志物可能是临床实践中评估心血管风险的有用辅助工具。联合评估动脉僵硬度和炎症标志物可能会改善心血管风险的无创评估,从而能够选择高危患者进行预防性治疗或更定期的体检。未来的去僵硬度治疗方法的开发可能针对促炎机制。