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Review
. 2013 May 1:11:117.
doi: 10.1186/1741-7015-11-117.

Immunity, atherosclerosis and cardiovascular disease

Johan Frostegård  1
Affiliations
Review

Immunity, atherosclerosis and cardiovascular disease

Johan Frostegård. BMC Med. .

Abstract

Atherosclerosis, the major cause of cardiovascular disease (CVD), is a chronic inflammatory condition with immune competent cells in lesions producing mainly pro-inflammatory cytokines. Dead cells and oxidized forms of low density lipoproteins (oxLDL) are abundant. The major direct cause of CVD appears to be rupture of atherosclerotic plaques. oxLDL has proinflammatory and immune-stimulatory properties, causes cell death at higher concentrations and contains inflammatory phospholipids with phosphorylcholine (PC) as an interesting epitope. Antibodies against PC (anti-PC) may be atheroprotective, one mechanism being anti-inflammatory. Bacteria and virus have been discussed, but it has been difficult to find direct evidence, and antibiotic trials have not been successful. Heat shock proteins could be one major _target for atherogenic immune reactions. More direct causes of plaque rupture include pro-inflammatory cytokines, chemokines, and lipid mediators. To prove that inflammation is a cause of atherosclerosis and CVD, clinical studies with anti-inflammatory and/or immune-modulatory treatment are needed. The potential causes of immune reactions and inflammation in atherosclerosis and how inflammation can be _targeted therapeutically to provide novel treatments for CVD are reviewed.

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Figures

Figure 1
Figure 1
Schematic illustration of an atherosclerotic plaque, with plaque rupture as a complication. Potential underlying causes of inflammation and immune reactions are depicted. Illustration by Gunilla Elam.
See this image and copyright information in PMC

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