Dimosiari Athina, Patoulias Dimitrios, Kitas George D, Dimitroulas Theodoros
Second Department of Internal Medicine, European Interbalkan Medical Center, 57001 Thessaloniki, Greece.
Outpatient Department of Cardiometabolic Medicine, Second Department of Cardiology, General Hospital Hippokration, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.
J Clin Med. 2023 Feb 6;12(4):1302. doi: 10.3390/jcm12041302.
Cardiovascular disease (CVD) constitutes a real pandemic of the 21st century. According to data from the Centers for Disease Control and Prevention, one person dies every 34 min due to some form of CVD in the United States. Apart from the extremely high morbidity and mortality accompanying CVD, the economic burden seems to be unbearable even for developed countries in the Western World. The role of inflammation in the development and progression of CVD appears to be crucial, while, various inflammatory pathways, such as the Nod-like receptor protein 3 (NLRP3) inflammasome-interleukin (IL)-1/IL-6 pathway of the innate immunity, have attracted scientific interest during the last decade, as a potential treatment target in primary and/or secondary prevention of CVD. Whereas there is a significant amount of evidence, stemming mainly from observational studies, concerning the cardiovascular safety of IL-1 and IL-6 antagonists in patients with rheumatic diseases, evidence from relevant randomized controlled trials (RCTs) is rather scarce and conflicting, especially for patients without underlying rheumatic disease. In this review, we summarize and critically present the currently available evidence, both from RCTs and observational studies, concerning the place that IL-1 and IL-6 antagonists may hold in the treatment of CVD.
心血管疾病（CVD）是21世纪名副其实的大流行病。根据美国疾病控制与预防中心的数据，在美国，每34分钟就有一人死于某种形式的心血管疾病。除了心血管疾病伴随的极高发病率和死亡率外，即使对于西方世界的发达国家来说，其经济负担似乎也难以承受。炎症在心血管疾病的发生和发展中所起的作用似乎至关重要，同时，各种炎症途径，如天然免疫的核苷酸结合寡聚化结构域样受体蛋白3（NLRP3）炎性小体-白细胞介素（IL）-1/IL-6途径，在过去十年中作为心血管疾病一级和/或二级预防的潜在治疗靶点引起了科学界的关注。虽然有大量主要来自观察性研究的证据表明IL-1和IL-6拮抗剂对风湿性疾病患者心血管安全性的影响，但来自相关随机对照试验（RCT）的证据相当稀少且相互矛盾，尤其是对于没有潜在风湿性疾病的患者。在本综述中，我们总结并批判性地呈现了目前来自随机对照试验和观察性研究的现有证据，这些证据涉及IL-1和IL-6拮抗剂在心血管疾病治疗中可能占据的地位。
