Rao Sunil V, Lerner Johanna Ben-Ami
Department of Medicine, Division of Cardiology, New York University Langone Medical Center, NYU Langone Health System, 550 1st Ave, New York, NY, 10010, USA.
Curr Atheroscler Rep. 2024 Dec 23;27(1):20. doi: 10.1007/s11883-024-01263-x.
Inflammation has been demonstrated to negatively impact patients in the peri-ACS period. This narrative review outlines the inflammatory response in ACS, highlighting the role of the NLRP3 inflammasome pathway following acute plaque rupture and coronary intervention and its potential as a pharmacologic target. RECENT: nvestigators have leveraged medications targeting the NLRP3 inflammasome currently used for other inflammatory pathologies, including colchicine, tocilizumab and anakinra. Investigation into these drugs in the peri-ACS period has yielded varying results, with the most encouraging findings in ACS patients treated with tocilizumab. More conflicting data exists for the role of colchicine and anakinra, with many studies limited in their power to detect clinical outcomes and heterogeneity in their patient populations and endpoints. Despite conflicting data, the NLRP3 remains an attractive therapeutic target in the peri-ACS period. Further investigation is required to prove benefit and safety with large clinical trials adequately powered for clinical outcomes.
炎症已被证明会对急性冠状动脉综合征（ACS）围手术期的患者产生负面影响。本叙述性综述概述了ACS中的炎症反应，强调了急性斑块破裂和冠状动脉介入治疗后NLRP3炎性小体途径的作用及其作为药物靶点的潜力。近期：研究人员利用了目前用于其他炎症性疾病的靶向NLRP3炎性小体的药物，包括秋水仙碱、托珠单抗和阿那白滞素。在ACS围手术期对这些药物的研究产生了不同的结果，在接受托珠单抗治疗的ACS患者中发现了最令人鼓舞的结果。关于秋水仙碱和阿那白滞素的作用存在更多相互矛盾的数据，许多研究在检测临床结果的能力以及患者群体和终点的异质性方面存在局限性。尽管数据相互矛盾，但NLRP3仍然是ACS围手术期一个有吸引力的治疗靶点。需要进一步研究，通过有足够临床结果效力的大型临床试验来证明其益处和安全性。
