Atherosclerosis, the major underlying cause of cardiovascular diseases (CVD), is the number one killer globally. The disease pathogenesis involves a complex interplay between metabolic and immune components. Although lipid-lowering drugs such as statins curb the risks associated with CVD, significant residual inflammatory risk remains. Substantial evidence from experimental models and clinical studies has established the role of inflammation and immune effector mechanisms in the pathogenesis of atherosclerosis. Several stages of the disease are affected by host-mediated antigen-specific adaptive immune responses that play either protective or proatherogenic roles. Therefore, strategies to boost an anti-atherogenic humoral and T regulatory cell response are emerging as preventative or therapeutic strategies to lowering inflammatory residual risks. Vaccination holds promise as an efficient, durable and relatively inexpensive approach to induce protective adaptive immunity in atherosclerotic patients. In this review, we discuss the status and opportunities for a human atherosclerosis vaccine. We describe (1) some of the immunomodulatory therapeutic interventions tested in atherosclerosis (2) the immune targets identified in pre-clinical and clinical investigations (3) immunization strategies evaluated in animal models (4) past and ongoing clinical trials to examine the safety and efficacy of human atherosclerosis vaccines and (5) strategies to improve and optimize vaccination in humans (antigen selection, formulation, dose and delivery).

中文翻译：

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动脉粥样硬化疫苗的机会：从小鼠到人类。

动脉粥样硬化是心血管疾病 (CVD) 的主要根本原因，也是全球第一大杀手。该疾病的发病机制涉及代谢和免疫成分之间复杂的相互作用。尽管他汀类药物等降脂药物可以抑制与心血管疾病相关的风险，但仍然存在显着的残留炎症风险。来自实验模型和临床研究的大量证据已经确定了炎症和免疫效应机制在动脉粥样硬化发病机制中的作用。该疾病的几个阶段受到宿主介导的抗原特异性适应性免疫反应的影响，这些反应发挥保护性或促动脉粥样硬化作用。因此，增强抗动脉粥样硬化体液和 T 调节细胞反应的策略正在成为降低炎症残留风险的预防或治疗策略。疫苗接种有望作为一种有效、持久且相对便宜的方法来诱导动脉粥样硬化患者的保护性适应性免疫。在这篇综述中，我们讨论了人类动脉粥样硬化疫苗的现状和机遇。我们描述了 (1) 在动脉粥样硬化中测试的一些免疫调节治疗干预措施 (2) 在临床前和临床研究中确定的免疫靶点 (3) 在动物模型中评估的免疫策略 (4) 过去和正在进行的临床试验，以检查安全性和有效性人类动脉粥样硬化疫苗的功效以及（5）改善和优化人类疫苗接种的策略（抗原选择、配方、剂量和递送）。