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European Heart Journal Advance Access published online on October 30, 2009
European Heart Journal, doi:10.1093/eurheartj/ehp477
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

Treating inflammation in atherosclerotic cardiovascular disease: emerging therapies

Roland Klingenberg1,2,* and Göran K. Hansson2

1 Department of Cardiology, University Hospital Zurich, CH-8091 Zurich, Switzerland
2 Karolinska Institutet, Center for Molecular Medicine, Department of Medicine, Karolinska University Hospital, 17176 Stockholm, Sweden

Received 5 August 2009; revised 4 September 2009; accepted 9 October 2009 * Corresponding author. Tel: +41 44 255 8700, Fax: +41 44 255 8701, Email: roland.klingenberg{at}usz.ch or rklingenberg{at}gmx.de

Atherosclerosis constitutes the underlying disease to the clinical manifestations of myocardial infarction, stroke, and gangrene. Despite the success of statins, prevention of clinical events of atherosclerosis remains a major challenge in current-day cardiology. Research into the inflammatory nature of atherosclerosis has led to improved mechanistic understanding of its pathogenesis and to the identification of novel therapeutic targets discussed in this review. Recent genetic and epidemiological data document shared pathologies of chronic inflammatory diseases and atherosclerosis. Anti-inflammatory treatment regimens used in these diseases, including tumor necrosis factor-{alpha} blockade, IL-1 receptor antagonism, and leukotriene blockade may be beneficial also in patients with coronary artery disease. Enhancing inherent atheroprotective immunity by expansion of regulatory T cells may emerge as a future therapeutic strategy. Immunization strategies directed against atherosclerosis-related antigens such as epitopes within the low-density lipoprotein particle have been extensively studied in animal models and may enter the clinical stage. Success of these novel therapies will be critically dependent on the adequate identification of patients and choice of appropriate clinical endpoints.

Key Words: Atherosclerosis • Inflammation • Immunity • Therapies • Acute coronary syndromes


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