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当前下肢外周动脉疾病的医学治疗和血运重建:对亚临床慢性炎症的影响。

Current Medical Therapy and Revascularization in Peripheral Artery Disease of the Lower Limbs: Impacts on Subclinical Chronic Inflammation.

机构信息

Cardiovascular Internal Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy.

Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Rome, Italy.

出版信息

Int J Mol Sci. 2023 Nov 8;24(22):16099. doi: 10.3390/ijms242216099.

DOI:10.3390/ijms242216099
PMID:38003290
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10671371/
Abstract

Peripheral artery disease (PAD), coronary artery disease (CAD), and cerebrovascular disease (CeVD) are characterized by atherosclerosis and inflammation as their underlying mechanisms. This paper aims to conduct a literature review on pharmacotherapy for PAD, specifically focusing on how different drug classes target pro-inflammatory pathways. The goal is to enhance the choice of therapeutic plans by considering their impact on the chronic subclinical inflammation that is associated with PAD development and progression. We conducted a comprehensive review of currently published original articles, narratives, systematic reviews, and meta-analyses. The aim was to explore the relationship between PAD and inflammation and evaluate the influence of current pharmacological and nonpharmacological interventions on the underlying chronic subclinical inflammation. Our findings indicate that the existing treatments have added anti-inflammatory properties that can potentially delay or prevent PAD progression and improve outcomes, independent of their effects on traditional risk factors. Although inflammation-targeted therapy in PAD shows promising potential, its benefits have not been definitively proven yet. However, it is crucial not to overlook the pleiotropic properties of the currently available treatments, as they may provide valuable insights for therapeutic strategies. Further studies focusing on the anti-inflammatory and immunomodulatory effects of these treatments could enhance our understanding of the mechanisms contributing to the residual risk in PAD and pave the way for the development of novel therapies.

摘要

外周动脉疾病(PAD)、冠状动脉疾病(CAD)和脑血管疾病(CeVD)的特征是动脉粥样硬化和炎症,这是其潜在机制。本文旨在对 PAD 的药物治疗进行文献综述,特别是关注不同药物类别如何靶向促炎途径。目标是通过考虑它们对与 PAD 发展和进展相关的慢性亚临床炎症的影响,来增强治疗方案的选择。我们对目前已发表的原始文章、叙述性综述、系统评价和荟萃分析进行了全面综述。目的是探讨 PAD 与炎症之间的关系,并评估当前药物和非药物干预对潜在慢性亚临床炎症的影响。我们的研究结果表明,现有的治疗方法具有附加的抗炎特性,可能会延迟或预防 PAD 的进展并改善预后,而与它们对传统危险因素的影响无关。尽管针对 PAD 的炎症靶向治疗显示出有希望的潜力,但尚未明确证明其益处。然而,至关重要的是,不要忽视当前可用治疗方法的多效性特性,因为它们可能为治疗策略提供有价值的见解。进一步研究这些治疗方法的抗炎和免疫调节作用,可以增强我们对导致 PAD 残余风险的机制的理解,并为新型治疗方法的发展铺平道路。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbc9/10671371/42bd8f71cdda/ijms-24-16099-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbc9/10671371/42bd8f71cdda/ijms-24-16099-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbc9/10671371/42bd8f71cdda/ijms-24-16099-g001.jpg

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