Роль воспаления в патогенезе атеросклероза

М.И. Казакова, Е.А. Высоцкая, Н.П. Митьковская

Республиканский клинический медицинский центр Управления делами Президента Республики Беларусь, Минск, Беларусь; Белорусский государственный медицинский университет, Минск, Беларусь; Республиканский научно-практический центр «Кардиология», Минск, Беларусь

Несмотря на достижения в области диагностики и лечения пациентов с ишемической болезнью сердца, частота развития сердечно-сосудистых осложнений остается достаточно большой. Основной причиной развития ишемических заболеваний сердечно-сосудистой системы является атеросклероз.
За последние три десятилетия были получены результаты исследований, свидетельствующие о том, что атеросклероз является воспалительным заболеванием. Широко признано, что как врожденный, так и адаптивный иммунный ответ важны для инициации и прогрессирования атеросклероза, который в основном состоит из моноцитов, макрофагов, нейтрофилов, Т-лимфоцитов и В-лимфоцитов. Кроме того, известно, что воспалительные биомаркеры, такие как высокочувствительный С-реактивный белок и интерлейкин-6, предсказывают будущие сердечно-сосудистые события, а также обычный холестерин липопротеинов низкой или высокой плотности.
Таким образом, современное понимание воспалительных механизмов атеросклероза привело к изучению новых терапевтических подходов, при которых уменьшение сосудистого воспаления само по себе может снизить частоту критических сердечно-сосудистых событий. В представленной обзорной статье сначала обрисованы механизмы развития атеросклероза, уделяя особое внимание их воспалительным аспектам, затем представлены несколько критических биомаркеров воспаления, которые могут быть использованы для стратификации сердечного риска у пациентов с ишемической болезнью сердца.

ключевые слова: атеросклероз, воспаление, цитокины, нейтрофильно-лимфоцитарный индекс, ревматические заболевания.

для цитирования: М.И. Казакова, Е.А. Высоцкая, Н.П. Митьковская. Роль воспаления в патогенезе атеросклероза. Неотложная кардиология и кардиоваскулярные риски, 2022, Т. 6, № 2, С. 1707–1713.

The role of inflammation in the pathogenesis of atherosclerosis

M. Kazakova, K. Vysotskaya, N. Mitkovskaya

Despite advances in the field of diagnosis and treatment of patients with coronary heart disease, the incidence of cardiovascular complications remains quite high. The main factor in the development of ischemic diseases of the cardiovascular system is atherosclerosis.
Over the past three years, research findings have been obtained indicating that atherosclerosis is an inflammatory disease. It is widely accepted that both innate and adaptive immune responses are important for initiation and progression of atherosclerosis, which mainly consist of monocytes, macrophages, neutrophils, T lymphocytes, and B lymphocytes. Moreover, inflammatory biomarkers such as high-sensitivity C-reactive protein and interleukin-6 are known to predict future cardiovascular events, as well as conventional low-density or high-density lipoprotein cholesterol.
Thus, current understanding of the inflammatory mechanisms of atherosclerosis have led us to explore novel therapeutic approaches that reducing vascular inflammation itself could lower the rates of critical cardiovascular events. In this review, we will first outline the mechanisms of atherosclerosis, especially focusing on their inflammatory aspects. Then we will introduce several critical inflammatory biomarkers that contribute to risk stratification of clinical cardiovascular events.

keywords: atherosclerosis, inflammation, cytokines, neutrophil-lymphocytic index, rheumatic diseases.

for references: M. Kazakova, K. Vysotskaya, N. Mitkovskaya. The role of inflammation in the pathogenesis of atherosclerosis. Neotlozhnaya kardiologiya i kardiovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2022, vol. 6, no. 2, pp. 1707–1713.

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