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Immune and Inflammation in Acute Coronary Syndrome: Molecular Mechanisms and Therapeutic Implications.
Journal of Immunology Research ( IF 3.5 ) Pub Date : 2020-08-18 , DOI: 10.1155/2020/4904217
Haiming Wang 1 , Zifan Liu 1 , Junjie Shao 2 , Lejian Lin 3 , Min Jiang 1 , Lin Wang 1 , Xuechun Lu 4 , Haomin Zhang 4 , Yundai Chen 1 , Ran Zhang 1
Affiliation  

Acute coronary syndrome (ACS) is a major cause of acute death worldwide. Both innate and adaptive immunity regulate atherosclerosis progression, plaque stability, and thrombus formation. Immune and inflammation dysfunction have been indicated in the pathogenesis of ACS. The imbalance in the proatherogenic and antiatherogenic immune networks promotes the transition of plaques from a stable to unstable state and results in the occurrence of acute coronary events. The residual inflammatory risk (RIR) has received increasing attention in recent years, and lowering RIR has been expected to improve the outcomes of ACS patients. The CANTOS, COLCOT, and LoDoCo trials verified the benefits of reducing cardiovascular events using anti-inflammation therapies; however, most of the other studies focusing on lowering RIR produced negative or contradicting results. Therefore, restoring the balance in autoimmune regulation is essential because proatherogenic and antiatherogenic immunomodulatory effects are equally important in the complex human immune network. In this review, we summarized the recent evidence of the roles of proatherogenic and antiatherogenic immune networks in the pathogenesis of ACS and discussed how immune and inflammation contribute to atherosclerosis progression, plaque instability, and adverse cardiovascular events. We also provide a “from bench to bedside” perspective of a novel and promising personalized strategy in RIR intervention and therapeutic approaches for the treatment of ACS.

中文翻译:

急性冠状动脉综合征的免疫和炎症:分子机制和治疗意义。

急性冠状动脉综合征(ACS)是全世界急性死亡的主要原因。先天免疫和适应性免疫均调节动脉粥样硬化的进展,斑块稳定性和血栓形成。在ACS的发病机制中已经表明了免疫和炎症功能障碍。促动脉粥样硬化和抗动脉粥样硬化免疫网络的不平衡促进了斑块从稳定状态转变为不稳定状态,并导致了急性冠状动脉事件的发生。近年来,残余炎性风险(RIR)受到越来越多的关注,降低RIR有望改善ACS患者的预后。CANTOS,COLCOT和LoDoCo试验验证了使用抗炎疗法减少心血管事件的益处;然而,其他大多数关注降低RIR的研究都产生了负面或矛盾的结果。因此,恢复自身免疫调节的平衡至关重要,因为促动脉粥样硬化和抗动脉粥样硬化的免疫调节作用在复杂的人类免疫网络中同样重要。在这篇综述中,我们总结了促动脉粥样硬化和抗动脉粥样硬化免疫网络在ACS发病机理中的作用的最新证据,并讨论了免疫和炎症如何促进动脉粥样硬化进展,斑块不稳定和不良心血管事件。我们还提供了从RIR干预和ACS治疗的新颖且有前途的个性化策略的“从长凳到床边”观点。恢复自身免疫调节的平衡至关重要,因为促动脉粥样硬化和抗动脉粥样硬化的免疫调节作用在复杂的人类免疫网络中同样重要。在这篇综述中,我们总结了促动脉粥样硬化和抗动脉粥样硬化免疫网络在ACS发病机理中的作用的最新证据,并讨论了免疫和炎症如何促进动脉粥样硬化进展,斑块不稳定和不良心血管事件。我们还提供了从RIR干预和ACS治疗的新颖且有前途的个性化策略的“从长凳到床边”观点。恢复自身免疫调节的平衡至关重要,因为促动脉粥样硬化和抗动脉粥样硬化的免疫调节作用在复杂的人类免疫网络中同样重要。在这篇综述中,我们总结了促动脉粥样硬化和抗动脉粥样硬化免疫网络在ACS发病机理中的作用的最新证据,并讨论了免疫和炎症如何促进动脉粥样硬化进展,斑块不稳定和不良心血管事件。我们还提供了从RIR干预和ACS治疗的新颖且有前途的个性化策略的“从长凳到床边”观点。我们总结了促动脉粥样硬化和抗动脉粥样硬化免疫网络在ACS发病机理中的作用的最新证据,并讨论了免疫和炎症如何促进动脉粥样硬化的进展,斑块不稳定和不良心血管事件。我们还提供了从RIR干预和ACS治疗的新颖且有前途的个性化策略的“从长凳到床边”观点。我们总结了促动脉粥样硬化和抗动脉粥样硬化免疫网络在ACS发病机理中的作用的最新证据,并讨论了免疫和炎症如何促进动脉粥样硬化的进展,斑块不稳定和不良心血管事件。我们还提供了从RIR干预和ACS治疗的新颖且有前途的个性化策略的“从长凳到床边”观点。
更新日期:2020-08-18
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