New approaches to pathogenetic anti-inflammatory therapy of cardiovascular diseases

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Abstract

In recent years, new data have been obtained confirming the role of inflammation as the leading pathogenetic mechanism for the development of atherosclerosis and its complications. In addition, atherosclerosis is considered in the spectrum of atypical autoinflammatory diseases.

The aim of the paper is to highlight the role of inflammation in the development and progression of atherosclerosis and other cardiovascular diseases as well as to identify new therapeutic targets for the treatment of cardiovascular disease.

The search has been performed in the PubMed, e-library, Embase, ClinicalTrials.gov databases, using the keywords: “inflammation”, “NLRP3 inflammasome”, “TNF-α”, “IL-1 blocker”, “atherosclerosis”, “cardiovascular disease”. As a result, 210 references have obtained; the results of 15 clinical studies have been selected for the final analysis as well as 15 papers containing the results of original studies with access to the full text articles in Russian or English.

The analysis of literature sources revealed that inflammation plays a crucial role in the development of cardiovascular diseases, and modern anti-inflammatory therapy is a promising, pathogenetically justified strategy for the prevention and treatment of cardiovascular diseases.

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About the authors

Ekaterina P. Kolesova

Almazov National Medical Research Centre

Author for correspondence.
Email: doctorkat82@mail.ru
ORCID iD: 0000-0002-1073-3844
SPIN-code: 1944-8903
Scopus Author ID: 56700084900

MD, Cand. Sci. (Med.)

Russian Federation, 2 Akkuratova St., Saint Petersburg, 197341

Alexey L. Maslyanskiy

Almazov National Medical Research Centre; Saint Petersburg State University

Email: esc_4@mail.ru
ORCID iD: 0000-0003-2427-4148
SPIN-code: 5698-7797
Scopus Author ID: 12545757200

MD, Dr. Sci. (Med.), Professor

Russian Federation, 2 Akkuratova St., Saint Petersburg, 197341; Saint Petersburg

Oxana P. Rotar

Almazov National Medical Research Centre

Email: rotari_oxana@mail.ru
ORCID iD: 0000-0002-5530-9772
SPIN-code: 2416-5178

MD, Dr. Sci. (Med.)

Russian Federation, 2 Akkuratova St., Saint Petersburg, 197341

Alexandra O. Konradi

Almazov National Medical Research Centre

Email: konradi@almazovcentre.ru
ORCID iD: 0000-0001-8169-7812
SPIN-code: 2298-8269

MD, Dr. Sci. (Med.), Professor, Academician of the RAS

Russian Federation, 2 Akkuratova St., Saint Petersburg, 197341

Vadim I. Mazurov

North-Western State Medical University named after I.I. Mechnikov

Email: maz.nwgmu@yandex.ru
ORCID iD: 0000-0002-0797-2051
SPIN-code: 6823-5482
Scopus Author ID: 16936315400

MD, Dr. Sci. (Med.), Professor, Academician of the RAS, Honored Scientist of the Russian Federation

Russian Federation, Saint Petersburg

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2. Fig. 1. The role of interleukin-1 in the pathogenesis of atherosclerosis [34]. (1) Lipoproteins in the lumen of the artery are involved in the formation of endothelial dysfunction, which leads to the accumulation of lipids and the migration of leukocytes into the intima of the vessel; (2) lipid modification and phagocytosis by leukocytes/macrophages, which is accompanied by the formation of the NLRP3 inflammasome, in which interleukin interleukin-1β and -18 are formed and secreted. These cytokines are involved in the processes of vasodilation, leukocyte activation and oxidative stress as well as the growth of atherosclerotic plaques and arterial remodeling; (3) interleukin IL-1 increases the level of blood clotting factors, promotes platelet activation, atherosclerotic plaque rupture and thrombosis. IL — interleukin

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3. Fig. 2. Current understanding of colchicine mechanism of action in atherosclerosis [35]. IL — interleukin; TNF-α — tumor necrosis factor alpha; VEGF — vascular endothelial growth factor

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