Amsterdam Cardiovascular Sciences, Amsterdam University Medical Center, location Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.
Department of Internal Medicine, Section of Nephrology, Amsterdam University Medical Centers, location Academic Medical Cente, University of Amsterdam, Amsterdam, Netherlands.
Nat Rev Cardiol. 2019 Jan;16(1):21-32. doi: 10.1038/s41569-018-0073-1.
Atherosclerosis is a chronic disease of the large arteries and the underlying cause of myocardial infarction and stroke. Atherosclerosis is driven by cholesterol accumulation and subsequent inflammation in the vessel wall. Despite the clinical successes of lipid-lowering treatments, atherosclerosis remains one of the major threats to human health worldwide. Over the past 20 years, insights into cardiovascular immunopathology have provided a plethora of new potential therapeutic targets to reduce the risk of atherosclerosis and have shifted the therapeutic focus from lipids to inflammation. In 2017, the CANTOS trial demonstrated for the first time the beneficial effects of targeting inflammation to treat cardiovascular disease by showing that IL-1β inhibition can reduce the recurrence rate of cardiovascular events in a large cohort of patients. At the same time, preclinical studies have highlighted nanotechnology approaches that facilitate the specific targeting of innate immune cells, which could potentially generate more effective immunomodulatory treatments to induce disease regression and prevent the recurrence of cardiovascular events. The clinical translation of such nanoimmunotherapies and their application to treat patients with ischaemic heart disease are challenges that lie ahead.
动脉粥样硬化是一种大血管的慢性疾病，也是心肌梗死和中风的根本原因。动脉粥样硬化是由胆固醇在血管壁内的积累和随后的炎症所驱动的。尽管降脂治疗在临床上取得了成功，但动脉粥样硬化仍然是全世界人类健康的主要威胁之一。在过去的 20 年里，对心血管免疫病理学的深入了解为减少动脉粥样硬化的风险提供了大量新的潜在治疗靶点，并将治疗重点从脂质转移到炎症。2017 年，CANTOS 试验首次证明了通过靶向炎症来治疗心血管疾病的有益效果，表明 IL-1β 抑制可以降低一大群患者心血管事件的复发率。与此同时，临床前研究强调了纳米技术方法，这些方法可以促进固有免疫细胞的特异性靶向，这可能会产生更有效的免疫调节治疗方法，以诱导疾病消退并预防心血管事件的复发。这种纳米免疫疗法的临床转化及其在治疗缺血性心脏病患者中的应用是未来的挑战。
