The Interplay of Lipids, Lipoproteins, and Immunity in Atherosclerosis

Angela Pirillo, Fabrizia Bonacina, Giuseppe Danilo Norata, Alberico Luigi Catapano

Research output: Contribution to journalReview article

Abstract

Purpose of Review: Atherosclerosis is an inflammatory disorder of the arterial wall, in which several players contribute to the onset and progression of the disease. Besides the well-established role of lipids, specifically cholesterol, and immune cell activation, new insights on the molecular mechanisms underlying the atherogenic process have emerged. Recent Findings: Meta-inflammation, a condition of low-grade immune response caused by metabolic dysregulation, immunological memory of innate immune cells (referred to as “trained immunity”), cholesterol homeostasis in dendritic cells, and immunometabolism, i.e., the interplay between immunological and metabolic processes, have all emerged as new actors during atherogenesis. These observations reinforced the interest in directly targeting inflammation to reduce cardiovascular disease. Summary: The novel acquisitions in pathophysiology of atherosclerosis reinforce the tight link between lipids, inflammation, and immune response, and support the benefit of targeting LDL-C as well as inflammation to decrease the CVD burden. How this will translate into the clinic will depend on the balance between costs (monoclonal antibodies either to PCSK9 or to IL-1ß), side effects (increased incidence of death due to infections for anti-IL-1ß antibody), and the benefits for patients at high CVD risk.

Original languageEnglish
Article number12
JournalCurrent Atherosclerosis Reports
Volume20
Issue number3
DOIs
Publication statusPublished - Mar 1 2018
Externally publishedYes

Keywords

  • Atherosclerosis
  • Cholesterol
  • Immune response
  • Inflammation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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