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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Main Authors: Michael Y. Henein, Sergio Vancheri, Giovanni Longo, Federico Vancheri
Format: Article
Language:English
Published: MDPI AG 2022-10-01
Series:International Journal of Molecular Sciences
Subjects:
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.
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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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