Novel Anti-Inflammatory Therapies in Coronary Artery Disease and Acute Coronary Syndromes
Evidence suggests that inflammation plays an important role in atherosclerosis and the consequent clinical presentation, including stable coronary artery disease (CAD) and acute coronary syndromes (ACS). The most essential elements are cytokines, proteins with hormone-like properties that are produc...
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MDPI AG
2023-07-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/13/8/1669 |
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| author | Yannis Dimitroglou Constantina Aggeli Panagiotis Theofilis Panagiotis Tsioufis Evangelos Oikonomou Christos Chasikidis Konstantinos Tsioufis Dimitris Tousoulis |
| author_facet | Yannis Dimitroglou Constantina Aggeli Panagiotis Theofilis Panagiotis Tsioufis Evangelos Oikonomou Christos Chasikidis Konstantinos Tsioufis Dimitris Tousoulis |
| author_sort | Yannis Dimitroglou |
| collection | DOAJ |
| description | Evidence suggests that inflammation plays an important role in atherosclerosis and the consequent clinical presentation, including stable coronary artery disease (CAD) and acute coronary syndromes (ACS). The most essential elements are cytokines, proteins with hormone-like properties that are produced by the immune cells, endothelial cells, platelets, fibroblasts, and some stromal cells. Interleukins (IL-1β and IL-6), chemokines, interferon-γ (IFN-γ), and tumor necrosis factor-alpha (TNF-α) are the cytokines commonly associated with endothelial dysfunction, vascular inflammation, and atherosclerosis. These molecules can be targeted by commonly used therapeutic substances or selective molecules that exert targeted anti-inflammatory actions. The most significant anti-inflammatory therapies are aspirin, statins, colchicine, IL-1β inhibitors, and IL-6 inhibitors, along with novel therapies such as TNF-α inhibitors and IL-1 receptor antagonists. Aspirin and statins are well-established therapies for atherosclerosis and CAD and their pleiotropic and anti-inflammatory actions contribute to their efficacy and favorable profile. Colchicine may also be considered in high-risk patients if recurrent ACS episodes occur when on optimal medical therapy according to the most recent guidelines. Recent randomized studies have also shown that therapies specifically targeting inflammatory interleukins and inflammation can reduce the risk for cardiovascular events, but these therapies are yet to be fully implemented in clinical practice. Preclinical research is also intense, targeting various inflammatory mediators that are believed to be implicated in CAD, namely repeated transfers of the soluble mutant of IFN-γ receptors, NLRP3 inflammasome inhibitors, IL-10 delivery by nanocarriers, chemokine modulatory treatments, and reacting oxygen species (ROS) targeting nanoparticles. Such approaches, although intriguing and promising, ought to be tested in clinical settings before safe conclusions can be drawn. Although the link between inflammation and atherosclerosis is significant, further studies are needed in order to elucidate this association and improve outcomes in patients with CAD. |
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| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T23:47:07Z |
| publishDate | 2023-07-01 |
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| record_format | Article |
| series | Life |
| spelling | doaj.art-05830e483c65481196bfc4227cff48d42023-11-19T01:53:51ZengMDPI AGLife2075-17292023-07-01138166910.3390/life13081669Novel Anti-Inflammatory Therapies in Coronary Artery Disease and Acute Coronary SyndromesYannis Dimitroglou0Constantina Aggeli1Panagiotis Theofilis2Panagiotis Tsioufis3Evangelos Oikonomou4Christos Chasikidis5Konstantinos Tsioufis6Dimitris Tousoulis7First Department of Cardiology, “Hippokration” General Hospital, University of Athens Medical School, 11527 Athens, GreeceFirst Department of Cardiology, “Hippokration” General Hospital, University of Athens Medical School, 11527 Athens, GreeceFirst Department of Cardiology, “Hippokration” General Hospital, University of Athens Medical School, 11527 Athens, GreeceFirst Department of Cardiology, “Hippokration” General Hospital, University of Athens Medical School, 11527 Athens, GreeceThird Department of Cardiology, Thoracic Diseases General Hospital “Sotiria”, University of Athens Medical School, 11527 Athens, GreeceDepartment of Cardiology, General Hospital of Corinth, 20100 Corinth, GreeceFirst Department of Cardiology, “Hippokration” General Hospital, University of Athens Medical School, 11527 Athens, GreeceFirst Department of Cardiology, “Hippokration” General Hospital, University of Athens Medical School, 11527 Athens, GreeceEvidence suggests that inflammation plays an important role in atherosclerosis and the consequent clinical presentation, including stable coronary artery disease (CAD) and acute coronary syndromes (ACS). The most essential elements are cytokines, proteins with hormone-like properties that are produced by the immune cells, endothelial cells, platelets, fibroblasts, and some stromal cells. Interleukins (IL-1β and IL-6), chemokines, interferon-γ (IFN-γ), and tumor necrosis factor-alpha (TNF-α) are the cytokines commonly associated with endothelial dysfunction, vascular inflammation, and atherosclerosis. These molecules can be targeted by commonly used therapeutic substances or selective molecules that exert targeted anti-inflammatory actions. The most significant anti-inflammatory therapies are aspirin, statins, colchicine, IL-1β inhibitors, and IL-6 inhibitors, along with novel therapies such as TNF-α inhibitors and IL-1 receptor antagonists. Aspirin and statins are well-established therapies for atherosclerosis and CAD and their pleiotropic and anti-inflammatory actions contribute to their efficacy and favorable profile. Colchicine may also be considered in high-risk patients if recurrent ACS episodes occur when on optimal medical therapy according to the most recent guidelines. Recent randomized studies have also shown that therapies specifically targeting inflammatory interleukins and inflammation can reduce the risk for cardiovascular events, but these therapies are yet to be fully implemented in clinical practice. Preclinical research is also intense, targeting various inflammatory mediators that are believed to be implicated in CAD, namely repeated transfers of the soluble mutant of IFN-γ receptors, NLRP3 inflammasome inhibitors, IL-10 delivery by nanocarriers, chemokine modulatory treatments, and reacting oxygen species (ROS) targeting nanoparticles. Such approaches, although intriguing and promising, ought to be tested in clinical settings before safe conclusions can be drawn. Although the link between inflammation and atherosclerosis is significant, further studies are needed in order to elucidate this association and improve outcomes in patients with CAD.https://www.mdpi.com/2075-1729/13/8/1669inflammationatherosclerosiscytokinesvascular inflammationacute coronary syndromesendothelial dysfunction |
| spellingShingle | Yannis Dimitroglou Constantina Aggeli Panagiotis Theofilis Panagiotis Tsioufis Evangelos Oikonomou Christos Chasikidis Konstantinos Tsioufis Dimitris Tousoulis Novel Anti-Inflammatory Therapies in Coronary Artery Disease and Acute Coronary Syndromes Life inflammation atherosclerosis cytokines vascular inflammation acute coronary syndromes endothelial dysfunction |
| title | Novel Anti-Inflammatory Therapies in Coronary Artery Disease and Acute Coronary Syndromes |
| title_full | Novel Anti-Inflammatory Therapies in Coronary Artery Disease and Acute Coronary Syndromes |
| title_fullStr | Novel Anti-Inflammatory Therapies in Coronary Artery Disease and Acute Coronary Syndromes |
| title_full_unstemmed | Novel Anti-Inflammatory Therapies in Coronary Artery Disease and Acute Coronary Syndromes |
| title_short | Novel Anti-Inflammatory Therapies in Coronary Artery Disease and Acute Coronary Syndromes |
| title_sort | novel anti inflammatory therapies in coronary artery disease and acute coronary syndromes |
| topic | inflammation atherosclerosis cytokines vascular inflammation acute coronary syndromes endothelial dysfunction |
| url | https://www.mdpi.com/2075-1729/13/8/1669 |
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