title: Immunomodulation of the inflammatory response in atherosclerosis.
abstract: OBJECTIVE
  Cardiovascular disease, as manifested in the formation of atherosclerotic lesions, can be described as a chronic inflammatory autoimmune-like disease that proceeds in the context of enhanced plasma lipid levels. Modulation of the immune response may therefore form a valuable therapy in addition to standardized cholesterol and blood pressure-lowering therapies. The purpose of this review is to describe a number of recent approaches to immunomodulate atherosclerosis: immunization against mediators involved in atherosclerosis, such as cytokines and modified low-density lipoprotein; intervention in cytokine pathways; intervention in co-stimulatory pathways; activation of regulatory T cells; and modulation of natural killer T cells.
  
  
  RESULTS
  The most recent findings point to an important role for regulatory T cells in atherosclerotic lesion formation. The function of the regulatory T cells is modulated by chemokines and by co-stimulatory pathways, whereas the function of these cells can be strongly upregulated by anti-CD3 treatment and tolerance induction.
  
  
  CONCLUSIONS
  In the near future the first exponents of this approach, such as immunization and enhancement of the function of regulatory T cells, may enter the first phase of clinical trials, and may ultimately add to the current therapies in atherosclerosis.
authors: Division of Biopharmaceutics, Leiden/Amsterdam Center for Drug Research, Leiden University, Leiden, The Netherlands. j.kuiper@lacdr.leidenuniv.nl
authors: Johan
authors: J
authors: Kuiper
authors: Gijs H M
authors: GH
authors: van Puijvelde
authors: Eva J A
authors: EJ
authors: van Wanrooij
authors: Thomas
authors: T
authors: van Es
authors: Kim
authors: K
authors: Habets
authors: Arnaud D
authors: AD
authors: Hauer
authors: Theo J C
authors: TJ
authors: van den Berkel
mesh_terms: D000818:Animals; D050197:Atherosclerosis / Q000276:immunology* / Q000378:metabolism; D016207:Cytokines / Q000276:immunology / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000276:immunology* / Q000378:metabolism; D015398:Signal Transduction / Q000276:immunology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology / Q000378:metabolism
chemical_list: D016207:Cytokines