Center for Molecular Cardiology, University of Zürich, Wagistrasse 12, Schlieren CH-8952, Switzerland.
Department of Internal Medicine, First Clinic of Internal Medicine, University of Genoa, v.le Benedetto XV 10, 16132 Genoa, Italy.
Eur Heart J. 2020 Aug 14;41(31):2974-2982. doi: 10.1093/eurheartj/ehz961.
The ongoing worldwide increase in life expectancy portends a rising prevalence of age-related cardiovascular (CV) diseases in the coming decades that demands a deeper understanding of their molecular mechanisms. Inflammation has recently emerged as an important contributor for CV disease development. Indeed, a state of chronic sterile low-grade inflammation characterizes older organisms (also known as inflamm-ageing) and participates pivotally in the development of frailty, disability, and most chronic degenerative diseases including age-related CV and cerebrovascular afflictions. Due to chronic activation of inflammasomes and to reduced endogenous anti-inflammatory mechanisms, inflamm-ageing contributes to the activation of leucocytes, endothelial, and vascular smooth muscle cells, thus accelerating vascular ageing and atherosclerosis. Furthermore, inflamm-ageing promotes the development of catastrophic athero-thrombotic complications by enhancing platelet reactivity and predisposing to plaque rupture and erosion. Thus, inflamm-ageing and its contributors or molecular mediators might furnish targets for novel therapeutic strategies that could promote healthy ageing and conserve resources for health care systems worldwide. Here, we discuss recent findings in the pathophysiology of inflamm-ageing, the impact of these processes on the development of age-related CV diseases, results from clinical trials targeting its components and the potential implementation of these advances into daily clinical practice.
全球范围内预期寿命的持续增长预示着未来几十年与年龄相关的心血管(CV)疾病的患病率将会上升,这需要我们更深入地了解其分子机制。炎症最近已成为 CV 疾病发展的一个重要因素。事实上,慢性低度非传染性炎症状态是老年生物体的特征(也称为炎性衰老),并在虚弱、残疾和大多数慢性退行性疾病(包括与年龄相关的心血管和脑血管疾病)的发展中起着关键作用。由于炎性小体的慢性激活和内源性抗炎机制的减少,炎性衰老会导致白细胞、内皮细胞和血管平滑肌细胞的激活,从而加速血管老化和动脉粥样硬化。此外,炎性衰老通过增强血小板反应性并导致斑块破裂和侵蚀,促进灾难性的动脉粥样硬化血栓并发症的发展。因此,炎性衰老及其相关因素或分子介质可能为新的治疗策略提供靶点,这些策略可以促进健康衰老,并为全球医疗保健系统节省资源。在这里,我们讨论了炎性衰老的病理生理学的最新发现,这些过程对与年龄相关的 CV 疾病发展的影响,针对其成分的临床试验结果以及将这些进展应用于日常临床实践的潜力。