Immune-mediated mechanisms in atherosclerosis: prevention and treatment of clinical manifestations.
Accumulation of inflammatory cells identifies atherosclerotic plaque at risk for rupture. Typically, activated immune cells occupy the rupture-prone areas of the atherosclerotic lesion. These cells are an appealing therapeutic target for novel strategies of plaque stabilization. Biologic consequences of plaque inflammation ultimately depend not only on the cellular players populating the lesion but also on triggers of immune activation originating from within the plaque or arriving from the circulation, and immune effector mechanisms that mediate cellular damage and plaque destabilization. Recent studies have provided insights into particular immune mechanisms in the atherosclerotic plaque that contribute to plaque vulnerability. This knowledge provides the basis for potential immunomodulatory therapies in cardiovascular disease. These therapeutic approaches can be classified as (1) immunomodulatory effects of existing therapies, (2) therapies targeting inflammatory triggers, and (3) agents inhibiting specific immune mechanisms.
Niessner
A
A
Lowance Center for Human Immunology, Department of Medicine, Emory University School of Medicine, 101 Woodruff Circle, Atlanta, GA 30322, USA.
Goronzy
J J
JJ
Weyand
C M
CM
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy* / Q000821:virology; D001324:Autoantigens; D001428:Bacterial Vaccines / Q000627:therapeutic use; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D006360:Heat-Shock Proteins / Q000276:immunology; D006801:Humans; D007111:Immunity, Cellular; D007113:Immunity, Innate; D007155:Immunologic Factors / Q000627:therapeutic use; D007167:Immunotherapy / Q000379:methods*; D007249:Inflammation / Q000276:immunology / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy* / Q000821:virology; D008077:Lipoproteins, LDL / Q000276:immunology; D014765:Viral Vaccines / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D001324:Autoantigens; D001428:Bacterial Vaccines; D002317:Cardiovascular Agents; D006360:Heat-Shock Proteins; D007155:Immunologic Factors; D008077:Lipoproteins, LDL; D014765:Viral Vaccines; C099252:oxidized low density lipoprotein