A sneaky vascular disease

[摘要] We are well past the hypothesis stage in recognizing that inflammation plays a seminal role in the development and expression of atherosclerotic vascular disease (ASCVD). The hypothesis has matured into a model where clinical trials are being conducted that may ultimately home in on defining specific anti-inflammatory strategies that will augment our current lipid- and thrombosis-directed therapies in limiting the occurrence of cardiovascular events. A specific monoclonal antibody inhibitor of interleukin 1 beta (IL-1 beta) has been shown to modestly reduce cardiovascular events. Weekly methotrexate in doses used fairly successfully in patients with rheumatoid arthritis was ineffective, whereas colchicine may have benefit in preventing atherosclerotic events. The mechanism or mechanisms of action of these latter two medications are incompletely understood, although it is believed that at least part of colchicine’s efficacy in treating gout is due to suppression of crystal-induced generation of IL-1 beta. The message seems to be that the model is correct, but specific proinflammatory targets still need to be identified.

[学科分类] 卫生学