Department of Cardiology, Herlev and Gentofte Hospital, Kildegaardsvej 18, DK-2900 Hellerup, Denmark.
Curr Pharm Des. 2018;24(3):281-290. doi: 10.2174/1381612824666180110102341.
Inflammation plays a significant role in atherosclerosis and cardiovascular disease (CVD). Patients with chronic inflammatory diseases are at increased risk of CVD, but it is debated whether this association is causal or dependent on shared risk factors, other exposures, genes, and/or inflammatory pathways. The current review summarizes epidemiological, clinical, and experimental data supporting the role of shared inflammatory mechanisms between atherosclerotic CVD and rheumatoid arthritis, psoriasis, inflammatory bowel disease, and periodontitis, respectively, and provides insights to future prospects in this area of research. Awareness of the role of inflammation in CVD in patients with chronic inflammatory diseases and the potential for anti-inflammatory therapy, e.g., with tumor necrosis factor-α inhibitors, to also reduce atherosclerotic CVD has evolved into guideline- based recommendations. These include regular CVD risk assessment, aggressive treatment of traditional CVD risk factors, and recognition of reduced CVD as an added benefit of strict inflammatory disease control. At present, chronic inflammatory diseases would appear to qualify as partners in crime and not merely innocent bystanders to CVD. However, definite incremental contributions of inflammation versus effects of the complex interplay with other CVD risk factors may never be fully elucidated and for the foreseeable future, inflammation is posed to maintain its current position as both a marker and a maker of CVD, with clinical utility both for identification of patient at risk of CVD and as target for therapy to reduce CVD.
炎症在动脉粥样硬化和心血管疾病 (CVD) 中起着重要作用。患有慢性炎症性疾病的患者患 CVD 的风险增加，但目前仍存在争议，即这种关联是因果关系还是取决于共同的危险因素、其他暴露、基因和/或炎症途径。本综述总结了支持动脉粥样硬化性 CVD 与类风湿关节炎、银屑病、炎症性肠病和牙周炎之间存在共同炎症机制的流行病学、临床和实验数据，并为该研究领域的未来前景提供了见解。在患有慢性炎症性疾病的患者中，认识到炎症在 CVD 中的作用以及抗炎治疗（例如使用肿瘤坏死因子-α抑制剂）也可能降低动脉粥样硬化性 CVD，这已经演变为基于指南的建议。这些建议包括定期进行 CVD 风险评估、积极治疗传统 CVD 危险因素以及认识到严格控制炎症性疾病可降低 CVD。目前，慢性炎症性疾病似乎是 CVD 的共犯，而不仅仅是 CVD 的无辜旁观者。然而，炎症与其他 CVD 危险因素复杂相互作用的影响之间的确切增量贡献可能永远无法完全阐明，在可预见的未来，炎症仍将保持其目前作为 CVD 的标志物和制造者的地位，在识别有 CVD 风险的患者和作为治疗靶点以降低 CVD 方面具有临床应用价值。
