Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand?
Inflammation plays an important role in all stages of atherosclerosis — from endothelial dysfunction, to formation of fatty streaks and atherosclerotic plaque, and its progression to serious complications, such as atherosclerotic plaque rupture. Although dyslipidemia is a key driver of atheroscleros...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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IMR Press
2023-01-01
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| Series: | Reviews in Cardiovascular Medicine |
| Subjects: | |
| Online Access: | https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401010 |
| _version_ | 1797937815630118912 |
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| author | Jelena Rakocevic Milan Dobric Milica Labudovic Borovic Katarina Milutinovic Sanela Milenkovic Miloje Tomasevic |
| author_facet | Jelena Rakocevic Milan Dobric Milica Labudovic Borovic Katarina Milutinovic Sanela Milenkovic Miloje Tomasevic |
| author_sort | Jelena Rakocevic |
| collection | DOAJ |
| description | Inflammation plays an important role in all stages of atherosclerosis — from endothelial dysfunction, to formation of fatty streaks and atherosclerotic plaque, and its progression to serious complications, such as atherosclerotic plaque rupture. Although dyslipidemia is a key driver of atherosclerosis, pathogenesis of atherosclerosis is now considered interplay between cholesterol and inflammation, with the significant role of the immune system and immune cells. Despite modern therapeutic approaches in primary and secondary cardiovascular prevention, cardiovascular diseases remain the leading cause of mortality worldwide. In order to reduce residual cardiovascular risk, despite the guidelines-guided optimal medical therapy, novel therapeutic strategies are needed for prevention and management of coronary artery disease. One of the innovative and promising approaches in atherosclerotic cardiovascular disease might be inflammation-targeted therapy. Numerous experimental and clinical studies are seeking into metabolic pathways underlying atherosclerosis, in order to find the most suitable pathway and inflammatory marker/s that should be the target for anti-inflammatory therapy. Many anti-inflammatory drugs have been tested, from the well-known broad range anti-inflammatory agents, such as colchicine, allopurinol and methotrexate, to targeted monoclonal antibodies specifically inhibiting a molecule included in inflammatory pathway, such as canakinumab and tocilizumab. To date, there are no approved anti-inflammatory agents specifically indicated for silencing inflammation in patients with coronary artery disease. The most promising results came from the studies which tested colchicine, and studies where the inflammatory-target was NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome/interleukin-1 beta (IL-1β)/interleukin-6 (IL-6)/C-reactive protein (CRP) pathway. A growing body of evidence, along with the ongoing clinical studies, suggest that the anti-inflammatory therapy might become an additional strategy in treating atherosclerotic cardiovascular disease. Herein we present an overview of the role of inflammation in atherosclerosis, the most important inflammatory markers chosen as targets of anti-inflammatory therapy, along with the critical review of the major clinical trials which tested non-targeted and targeted anti-inflammatory drugs in patients with atherosclerotic cardiovascular disease. |
| first_indexed | 2024-04-10T18:50:10Z |
| format | Article |
| id | doaj.art-37d10c9635f140eea19fc5d374168bdf |
| institution | Directory Open Access Journal |
| issn | 1530-6550 |
| language | English |
| last_indexed | 2024-04-10T18:50:10Z |
| publishDate | 2023-01-01 |
| publisher | IMR Press |
| record_format | Article |
| series | Reviews in Cardiovascular Medicine |
| spelling | doaj.art-37d10c9635f140eea19fc5d374168bdf2023-02-01T07:32:12ZengIMR PressReviews in Cardiovascular Medicine1530-65502023-01-012411010.31083/j.rcm2401010S1530-6550(22)00789-XAnti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand?Jelena Rakocevic0Milan Dobric1Milica Labudovic Borovic2Katarina Milutinovic3Sanela Milenkovic4Miloje Tomasevic5Institute of Histology and Embryology “Aleksandar Đ. Kostić”, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaInstitute for Cardiovascular Diseases “Dedinje”, 11000 Belgrade, SerbiaInstitute of Histology and Embryology “Aleksandar Đ. Kostić”, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaInstitute of Histology and Embryology “Aleksandar Đ. Kostić”, Faculty of Medicine, University of Belgrade, 11000 Belgrade, SerbiaFaculty of Pharmacy, University of Belgrade, 11000 Belgrade, SerbiaDepartment of Internal Medicine, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, SerbiaInflammation plays an important role in all stages of atherosclerosis — from endothelial dysfunction, to formation of fatty streaks and atherosclerotic plaque, and its progression to serious complications, such as atherosclerotic plaque rupture. Although dyslipidemia is a key driver of atherosclerosis, pathogenesis of atherosclerosis is now considered interplay between cholesterol and inflammation, with the significant role of the immune system and immune cells. Despite modern therapeutic approaches in primary and secondary cardiovascular prevention, cardiovascular diseases remain the leading cause of mortality worldwide. In order to reduce residual cardiovascular risk, despite the guidelines-guided optimal medical therapy, novel therapeutic strategies are needed for prevention and management of coronary artery disease. One of the innovative and promising approaches in atherosclerotic cardiovascular disease might be inflammation-targeted therapy. Numerous experimental and clinical studies are seeking into metabolic pathways underlying atherosclerosis, in order to find the most suitable pathway and inflammatory marker/s that should be the target for anti-inflammatory therapy. Many anti-inflammatory drugs have been tested, from the well-known broad range anti-inflammatory agents, such as colchicine, allopurinol and methotrexate, to targeted monoclonal antibodies specifically inhibiting a molecule included in inflammatory pathway, such as canakinumab and tocilizumab. To date, there are no approved anti-inflammatory agents specifically indicated for silencing inflammation in patients with coronary artery disease. The most promising results came from the studies which tested colchicine, and studies where the inflammatory-target was NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome/interleukin-1 beta (IL-1β)/interleukin-6 (IL-6)/C-reactive protein (CRP) pathway. A growing body of evidence, along with the ongoing clinical studies, suggest that the anti-inflammatory therapy might become an additional strategy in treating atherosclerotic cardiovascular disease. Herein we present an overview of the role of inflammation in atherosclerosis, the most important inflammatory markers chosen as targets of anti-inflammatory therapy, along with the critical review of the major clinical trials which tested non-targeted and targeted anti-inflammatory drugs in patients with atherosclerotic cardiovascular disease.https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401010coronary artery diseaseinflammationanti-inflammatory therapycrpil-6il-1βcanakinumabtocilizumabcolchicine |
| spellingShingle | Jelena Rakocevic Milan Dobric Milica Labudovic Borovic Katarina Milutinovic Sanela Milenkovic Miloje Tomasevic Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand? Reviews in Cardiovascular Medicine coronary artery disease inflammation anti-inflammatory therapy crp il-6 il-1β canakinumab tocilizumab colchicine |
| title | Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand? |
| title_full | Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand? |
| title_fullStr | Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand? |
| title_full_unstemmed | Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand? |
| title_short | Anti-Inflammatory Therapy in Coronary Artery Disease: Where Do We Stand? |
| title_sort | anti inflammatory therapy in coronary artery disease where do we stand |
| topic | coronary artery disease inflammation anti-inflammatory therapy crp il-6 il-1β canakinumab tocilizumab colchicine |
| url | https://www.imrpress.com/journal/RCM/24/1/10.31083/j.rcm2401010 |
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