慢性炎症与动脉粥样硬化关系的研究进展

动脉粥样硬化(atherosclerosis,AS)的发病机制非常复杂,对其研究经历了一个半世纪,直到1999年Ross提出"动脉粥样硬化是一种炎症性疾病",各种炎症细胞和炎症因子参与动脉粥样硬化的发生和发展过程。已有众多的基础和临床研究都证实炎症在AS中的重要作用,但仍需要对AS发生发展的深入研究,使我们更准确认识和有效的防治AS。本文就近年来慢性炎症与动脉粥样硬化关系的研究进展作一综述。     

5-脂氧化酶与动脉粥样硬化的研究进展

动脉粥样硬化（AS）及其并发症是当今世界上导致死亡的最常见的病因之一。AS发病机制有多种学说,其中动脉粥样硬化是一种慢性炎症性疾病的学说已为广大学者所接受。白三烯（LTs）是促进炎症反应的脂类调控因子,在心血管组织中具有强烈的致炎作用,5-脂氧化酶（5-LO）能够氧化花生四烯酸生成LTs等花生酸类物质。近年对动脉粥样硬化的研究中发现5-LO途径及其下游产物LTs对AS的形成、发展及动脉粥样硬化斑块的不稳定性有重要作用。本文结合国内外文献,对5-LO基因结构、蛋白结构和代谢活性等生物学特性以及5-LO及其下游产物与动脉粥样硬化发生、发展的关系进行了总结,对了解和研究动脉粥样硬化疾病及其治疗具有重要意义。     

MAPKs信号通路在动脉粥样硬化发生发展中的调控作用

丝裂原激活蛋白激酶(mitogen-activated protein kinases,MAPKs)信号通路是生物体内重要的信号传导通路,其主要参与调控细胞的增殖、生长、分化、凋亡和炎症反应等多种生理病理过程。MAPKs信号通路在多种心血管疾病的病理过程中起着重要调控作用。动脉粥样硬化(athrosclerosis,AS)所致的各种急重症严重危害人类的健康,发病率呈逐年上升的趋势,但是动脉粥样硬化发生发展的分子机制尚不完全清楚。近年来,MAPKs信号通路在动脉粥样硬化(athrosclerosis,AS)的发生发展中的作用已成为是研究的热点。     

NLRP3炎症小体及其相关通路与动脉粥样硬化研究进展

动脉粥样硬化所导致的心血管病是人类致死致残的重要原因。炎症因素作为重要危险因素已得到研究者共识,越来越多的证据表明炎症参与了从早期内皮功能障碍到晚期斑块破裂的AS形成的各个阶段。CANTOS研究作为测试AS炎症假说的第一个大规模临床试验,为寻找IL-1β介导的炎症性AS的潜在治疗靶点提供依据。Nod样受体蛋白3炎症小体作为固有免疫系统的一种识别受体,可引起半胱氨酸天冬氨酸特异性蛋白酶1激活,产生和释放成熟的促炎因子白细胞介素1-β,参与炎症反应发生发展。本文对胆固醇结晶,氧化低密度脂蛋白,血流动力学改变,斑块内细胞代谢方式变化等对NLRP3炎症体激活机制以及NLRP3炎症小体的激活途径和临床治疗方法进行综述,以期通过对NLRP3及其相关通路的研究,为临床动脉粥样硬化治疗提供新思路。     

胆固醇结晶激活动脉粥样硬化斑块巨噬细胞NLRP3炎症体的途径

动脉粥样硬化既是胆固醇在血管壁聚集的疾病,也是发生在动脉壁的一种低强度慢性炎症形式。近年来有研究证实胆固醇结晶在动脉粥样硬化发生发展中具有重要作用。新的显微技术证实,胆固醇结晶在动脉粥样硬化斑块形成的早期即已出现,并与早期炎症有关。胆固醇结晶通过诱发局部炎症,促进大的脂质核心形成;刺破纤维帽,导致斑块破裂进而促进动脉粥样硬化斑块的进展。在影响斑块进程中,NLRP3炎症体的激活对此发挥了重要的作用。NLRP3炎症体是研究最多最明确的炎症体,其与非炎症性疾病的发生发展密切相关。以胆固醇结晶激活NLRP3炎症体的途径作为研究靶点,为动脉粥样硬化的诊断和治疗提供了新的思路和方法。该文就胆固醇结晶在动脉粥样硬化斑块中激活巨噬细胞NLRP3炎症体的两种途径做一综述。     

C反应蛋白与动脉粥样硬化

C反应蛋白（C-reactiveprotein,CRP）是人类非特异性急性期蛋白,是判断组织损伤和炎症反应的敏感指标之一。CRP的表达水平与动脉粥样硬化（atherosclerosis,AS）和心血管疾病的发生具有冠著的相关性。但是关于CRP是否是AS的独立危险因素并参与AS的发病机制,目前尚存在很大争议。新近的研究发现,CRP与某些特定的配体结合后,五聚体结构CRP可分离形成单体结构CRP。这一发现为研究CRP蛋白与AS的相互关系提供了新的线索,对CRP及其单体结构的深入研究,将有可能帮助人们找到治疗心血管疾病的有效方法。就炎性反应标志物CRP及其单体（monomeric CRP,mCRP）与动脉粥样硬化的相关研究进展进行综述,以探讨分析CRP在AS中的作用。     

动脉粥样硬化脂代谢紊乱与DNA甲基化的关系

心血管疾病是导致人类死亡的主要原因之一,动脉粥样硬化(Atherosclerosis,As)是心血管疾病的重要病理基础,炎症反应是动脉粥样硬化的重要病理机制。脂代谢紊乱是动脉粥样硬化的独立危险因素,贯穿动脉粥样硬化的始终,并且是导致炎症反应发生的重要原因。DNA甲基化是一种不改变基因核苷酸序列而能调控基因表达的一种重要的表观遗传学方式。有研究证明,脂代谢紊乱的发生、发展与DNA甲基化存在密切关系。本文将围绕与脂代谢紊乱相关基因对动脉粥样硬化过程中脂代谢紊乱与DNA甲基化的关系做一综述。     

过氧化物酶体增生激活型受体γ与AS

过氧化物酶体增生激活型受体γ（PPARγ）在组织中较为广泛地表达,主要是调节脂肪细胞分化、糖稳态,为噻唑烷二酮类抗糖尿病药物的生物学受体。PPARγ表达增强或激活可调节脂质代谢,抑制单核／巨噬细胞功能,减少细胞粘附分子和其他炎症介质的产生和释放,并抑制血管平滑肌产殖和迁移;可能改善某些动脉粥样硬化（atherosclerosis,AS)的危险因素,在AS的发生发展过程中具有重要意义。     

炎症与动脉粥样硬化及冠状动脉疾病的关系

炎症在冠状动脉疾病和其他动脉粥样硬化性疾病中起着重要作用.在动脉粥样硬化早期病变处存在大量的免疫细胞,它们所分泌的一系列细胞因子加速病变的进程,激活炎症反应导致急性冠脉综合症的发生.动脉粥样硬化,是冠状动脉疾病的主要病因,是一种炎性疾病,炎症因子参与到免疫反应过程中,使得动脉壁处的病变得以发生、蔓延和活化.     

Toll样受体4对动脉粥样硬化发生、发展的研究进展

动脉粥样硬化（atherosclerosis,AS）是多种细胞、炎性介质参与形成的慢性炎症性疾病。Toll样受体家族（Toll like receptors,TLRs）中的TLR4是机体重要的诱导分泌多种炎性因子的模式识别受体。现有证据表明,TLR4不仅产生多种炎性因子诱发血管炎症反应,而且促进AS斑块形成和发展,造成斑块不稳定,甚至破裂,对AS的发生、发展具有重要作用。因此,了解TLR4对AS的影响有助于发现新的治疗靶点和对策。主要对TLR4在AS发病机制和易损斑块发展中的作用进行综述。     

Exosome derived from CD137‐modified endothelial cells regulates the Th17 responses in atherosclerosis

The role of exosomes derived from endothelial cells (ECs) in the progression of atherosclerosis (AS) and inflammation remains largely unexplored. We aimed to investigate whether exosome derived from CD137‐modified ECs (CD137‐Exo) played a major role in AS and to elucidate the potential mechanism underlying the inflammatory effect. Exosomes derived from mouse brain microvascular ECs treated with agonist anti‐CD137 antibody were used to explore the effect of CD137 signalling in AS and inflammation in vitro and vivo. CD137‐Exo efficiently induced the progression of AS in ApoE^?/? mice. CD137‐Exo increased the proportion of Th17 cells both in vitro and vivo. The IL‐6 contained in CD137‐Exo which is regulated by Akt and NF‐КB pathway was verified to activate Th17 cell differentiation. IL‐17 increased apoptosis, inhibited cell viability and improved lactate dehydrogenase (LDH) release in ECs subjected to inflammation induced by lipopolysaccharide (LPS). The expression of soluble intercellular adhesion molecule1 (sICAM‐1), monocyte chemoattractant protein‐1 (MCP‐1) and E‐selectin in the supernatants of ECs after IL‐17 treatment was dramatically increased. CD137‐Exo promoted the progression of AS and Th17 cell differentiation via NF‐КB pathway mediated IL‐6 expression. This finding provided a potential method to prevent local and peripheral inflammation in AS.     

Role of vascular smooth muscle cell in the inflammation of atherosclerosis

Atherosclerosis is a pathologic process occurring within the artery, in which many cell types, including T cell, macrophages, endothelial cells, and smooth muscle cells, interact, and cause chronic inflammation, in response to various inner- or outer-cellular stimuli. Atherosclerosis is characterized by a complex interaction of inflammation, lipid deposition, vascular smooth muscle cell proliferation, endothelial dysfunction, and extracellular matrix remodeling, which will result in the formation of an intimal plaque. Although the regulation and function of vascular smooth muscle cells are important in the progression of atherosclerosis, the roles of smooth muscle cells in regulating vascular inflammation are rarely focused upon, compared to those of endothelial cells or inflammatory cells. Therefore, in this review, we will discuss here how smooth muscle cells contribute or regulate the inflammatory reaction in the progression of atherosclerosis, especially in the context of the activation of various membrane receptors, and how they may regulate vascular inflammation. [BMB Reports 2014; 47(1): 1-7]     

Mechanisms of anti-atherosclerotic functions of soy-based diets

Soy-based diets have been reported to protect against the development of atherosclerosis. However, the underlying mechanism(s) for this protection remains unknown. Although atherosclerosis was traditionally considered a disease associated with impaired lipid metabolism, in recent years the inflammatory components of atherosclerosis have been explored. Recent studies have convincingly delineated that uncontrolled chronic inflammation is the principal contributing factor for the initiation and progression of atherosclerosis. Interaction between activated monocytes and vascular endothelial cells is an early event in atherogenesis. The adhesion of leukocytes, including monocytes, to the inflamed-vascular endothelium and their transmigration into intima initiate the inflammatory processes. Following transmigration, monocytes in the intima are transformed to macrophages, which take up oxidized-LDL (oxLDL) to generate lipid-laden macrophages, also known as foam cells. Hence, in this review article the inflammatory processes associated with atherosclerosis and possible anti-inflammatory functions of soy-based diets contributing to the prevention of atherosclerosis are presented.     

Pharmacological targeting of HSP90 with 17-AAG induces apoptosis of myogenic cells through activation of the intrinsic pathway

Endothelial inflammation and monocyte plays an essential role in the initiation and progression of atherosclerosis. Ghrelin is beneficial for atherosclerosis progression. However, the detailed and precise molecular mechanisms of how ghrelin regulates endothelial inflammation are not clear. In this study, we investigated the regulation mechanism of ghrelin on TNF-α-activated endothelial inflammation and monocyte adhesion. It was found that TNF-α-induced monocyte adhesion on HUVEC was significantly attenuated by ghrelin. Furthermore, we found that ghrelin effectively suppressed TNF-α-induced inflammatory factors’ (including ICAM-1, VCAM-1, MCP-1, and IL-1β) expression through inhibiting AMPK phosphorylation and p65 expression both in HUVEC and THP-1. This phenomenon was further demonstrated by using AMPK agonist AICAR and inhibitor compound C, respectively. Our findings suggest that ghrelin may mediate TNF-α-induced endothelial inflammation and monocyte adhesion, in part via AMPK/NF-κB signaling pathway. These novel anti-inflammatory and immunoregulatory actions of ghrelin may play a certain role in understanding the formation and development of atherosclerosis.     

Infliximab: 12 years of experience

Rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) are immune-mediated conditions that share an inflammatory mechanism fuelled by excessive cytokines, particularly TNF. Control of inflammation and rapid suppression of cytokines are important in treating these diseases. With this understanding and the corresponding advent of TNF inhibitors, RA patients, AS patients and PsA patients have found more choices than ever before and have greater hope of sustained relief. As a widely used TNF inhibitor, infliximab has a deep and established record of efficacy and safety data. Extensive evidence - from randomised controlled clinical trials, large registries and postmarketing surveillance studies - shows that infliximab effectively treats the signs and symptoms, provides rapid and prolonged suppression of inflammation, prevents radiologically observable disease progression and offers an acceptable safety profile in RA, AS and PsA. In very recent studies, investigators have observed drug-free remission in some patients. Additionally, infliximab may interfere with rapidly progressing disease in RA by early addition to methotrexate in patients with signs of an aggressive course. Finally, infliximab has been shown to reduce PsA clinical manifestations such as nail involvement. With our current understanding, substantial data and increasing confidence regarding use in practice, infliximab can be considered a well-known drug in our continued campaign against inflammatory rheumatic diseases.