The Role of Inflammation in Cardiovascular Disease
Atherosclerosis is a chronic inflammatory disease, in which the immune system has a prominent role in its development and progression. Inflammation-induced endothelial dysfunction results in an increased permeability to lipoproteins and their subendothelial accumulation, leukocyte recruitment, and p...
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MDPI AG
2022-10-01
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Online Access: | https://www.mdpi.com/1422-0067/23/21/12906 |
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author | Michael Y. Henein Sergio Vancheri Giovanni Longo Federico Vancheri |
author_facet | Michael Y. Henein Sergio Vancheri Giovanni Longo Federico Vancheri |
author_sort | Michael Y. Henein |
collection | DOAJ |
description | Atherosclerosis is a chronic inflammatory disease, in which the immune system has a prominent role in its development and progression. Inflammation-induced endothelial dysfunction results in an increased permeability to lipoproteins and their subendothelial accumulation, leukocyte recruitment, and platelets activation. Recruited monocytes differentiate into macrophages which develop pro- or anti-inflammatory properties according to their microenvironment. Atheroma progression or healing is determined by the balance between these functional phenotypes. Macrophages and smooth muscle cells secrete inflammatory cytokines including interleukins IL-1β, IL-12, and IL-6. Within the arterial wall, low-density lipoprotein cholesterol undergoes an oxidation. Additionally, triglyceride-rich lipoproteins and remnant lipoproteins exert pro-inflammatory effects. Macrophages catabolize the oxidized lipoproteins and coalesce into a lipid-rich necrotic core, encapsulated by a collagen fibrous cap, leading to the formation of fibro-atheroma. In the conditions of chronic inflammation, macrophages exert a catabolic effect on the fibrous cap, resulting in a thin-cap fibro-atheroma which makes the plaque vulnerable. However, their morphology may change over time, shifting from high-risk lesions to more stable calcified plaques. In addition to conventional cardiovascular risk factors, an exposure to acute and chronic psychological stress may increase the risk of cardiovascular disease through inflammation mediated by an increased sympathetic output which results in the release of inflammatory cytokines. Inflammation is also the link between ageing and cardiovascular disease through increased clones of leukocytes in peripheral blood. Anti-inflammatory interventions specifically blocking the cytokine pathways reduce the risk of myocardial infarction and stroke, although they increase the risk of infections. |
first_indexed | 2024-03-09T19:01:34Z |
format | Article |
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issn | 1661-6596 1422-0067 |
language | English |
last_indexed | 2024-03-09T19:01:34Z |
publishDate | 2022-10-01 |
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series | International Journal of Molecular Sciences |
spelling | doaj.art-59620c9d5c5b4ae2a9cd9de19868078c2023-11-24T04:59:14ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672022-10-0123211290610.3390/ijms232112906The Role of Inflammation in Cardiovascular DiseaseMichael Y. Henein0Sergio Vancheri1Giovanni Longo2Federico Vancheri3Institute of Public Health and Clinical Medicine, Umea University, 90187 Umea, SwedenInterventional Neuroradiology Department, Besançon University Hospital, 25000 Besançon, FranceCardiovascular and Interventional Department, S.Elia Hospital, 93100 Caltanissetta, ItalyDepartment of Internal Medicine, S.Elia Hospital, 93100 Caltanissetta, ItalyAtherosclerosis is a chronic inflammatory disease, in which the immune system has a prominent role in its development and progression. Inflammation-induced endothelial dysfunction results in an increased permeability to lipoproteins and their subendothelial accumulation, leukocyte recruitment, and platelets activation. Recruited monocytes differentiate into macrophages which develop pro- or anti-inflammatory properties according to their microenvironment. Atheroma progression or healing is determined by the balance between these functional phenotypes. Macrophages and smooth muscle cells secrete inflammatory cytokines including interleukins IL-1β, IL-12, and IL-6. Within the arterial wall, low-density lipoprotein cholesterol undergoes an oxidation. Additionally, triglyceride-rich lipoproteins and remnant lipoproteins exert pro-inflammatory effects. Macrophages catabolize the oxidized lipoproteins and coalesce into a lipid-rich necrotic core, encapsulated by a collagen fibrous cap, leading to the formation of fibro-atheroma. In the conditions of chronic inflammation, macrophages exert a catabolic effect on the fibrous cap, resulting in a thin-cap fibro-atheroma which makes the plaque vulnerable. However, their morphology may change over time, shifting from high-risk lesions to more stable calcified plaques. In addition to conventional cardiovascular risk factors, an exposure to acute and chronic psychological stress may increase the risk of cardiovascular disease through inflammation mediated by an increased sympathetic output which results in the release of inflammatory cytokines. Inflammation is also the link between ageing and cardiovascular disease through increased clones of leukocytes in peripheral blood. Anti-inflammatory interventions specifically blocking the cytokine pathways reduce the risk of myocardial infarction and stroke, although they increase the risk of infections.https://www.mdpi.com/1422-0067/23/21/12906atherosclerosisinflammationcoronary artery diseasestrokecerebral artery aneurysmcoronary atherosclerotic plaque |
spellingShingle | Michael Y. Henein Sergio Vancheri Giovanni Longo Federico Vancheri The Role of Inflammation in Cardiovascular Disease International Journal of Molecular Sciences atherosclerosis inflammation coronary artery disease stroke cerebral artery aneurysm coronary atherosclerotic plaque |
title | The Role of Inflammation in Cardiovascular Disease |
title_full | The Role of Inflammation in Cardiovascular Disease |
title_fullStr | The Role of Inflammation in Cardiovascular Disease |
title_full_unstemmed | The Role of Inflammation in Cardiovascular Disease |
title_short | The Role of Inflammation in Cardiovascular Disease |
title_sort | role of inflammation in cardiovascular disease |
topic | atherosclerosis inflammation coronary artery disease stroke cerebral artery aneurysm coronary atherosclerotic plaque |
url | https://www.mdpi.com/1422-0067/23/21/12906 |
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