Anti-inflammatory and Immunomodulatory Therapies in Atherosclerosis

Abstract

Hypercholesterolemia is a major risk factor in atherosclerosis development and lipid-lowering drugs (i.e., statins) remain the treatment of choice. Despite effective reduction of LDL cholesterol in patients, a residual cardiovascular risk persists in some individuals, highlighting the need for further therapeutic intervention. Recently, the CANTOS trial paved the way toward the development of specific therapies targeting inflammation, a key feature in atherosclerosis progression. The pre-existence of multiple drugs modulating both innate and adaptive immune responses has significantly accelerated the number of translational studies applying these drugs to atherosclerosis. Additional preclinical research has led to the discovery of new therapeutic targets, offering promising perspectives for the treatment and prevention of atherosclerosis. Currently, both drugs with selective targeting and broad unspecific anti-inflammatory effects have been tested. In this chapter, we aim to give an overview of current advances in immunomodulatory treatment approaches for atherosclerotic cardiovascular diseases.

Inhibition Effects of Nippostrongylus brasiliensis and Its Derivatives against Atherosclerosis in ApoE-/- Mice through Anti-Inflammatory Response

“…Mechanisms of AS initiation and progression have not been fully elucidated until now, although low-grade chronic inflammation was thought to play an important role [ 38 ]. Anti-inflammation therapeutic approaches, including anti-inflammatory drugs, biological therapies targeting cytokines and chemokines, and small molecule enzyme inhibitors and receptor antagonists, have all been attempted and have been shown to exert efficient antiatherosclerosis roles [ 6 , 39 , 40 ]. According to the present study, increased anti-inflammatory cytokine levels, including IL-4 and IL-10, were observed.…”

Molecular Mechanisms Underlying Pathological and Therapeutic Roles of Pericytes in Atherosclerosis

“…The treatment of AS was addressed in countless studies; despite the constant development of new therapeutic strategies and drugs (such as nanomedicine, decoy and anti-platelet drug-loaded targeted technologies) [ 98 , 99 , 100 ], lipid-lowering and anti-inflammatory drugs are currently used as the principal drug in the first- and second-line treatments to prevent coronary artery disease [ 101 , 102 ]. However, pericytes may suggest some new diagnoses and therapeutic strategies for AS and other vascular pathologies [ 13 ].…”

Enhancing Rheumatoid Arthritis Treatment by Subcutaneous Methotrexate Injections and Anti-IL-2 Antibody Synthesis

“…The ACR even advocates MTX monotherapy over other DMARDs, biological DMARDs (bDMARDs), or targeted synthetic DMARDs (tsDMARDs). MTX monotherapy is preferred over dual or triple csDMARD therapy and combination therapy with MTX plus a tumor necrosis factor inhibitor, according to ACR guidelines (Deroissart et al, 2021). In Japan, oral MTX gained approval in 1999 for RA treatment in adults and is now considered the primary choice by the Japan College of Rheumatology (Dubey et al, 1993).…”

“…MTX is generally well tolerated, with its primary adverse drug reactions encompassing hepatotoxicity, bone marrow toxicity, and gastrointestinal (GI) side effects. To counteract the antifolate properties of MTX, the concurrent use of folic acid or folinic acid is advised, a practice endorsed by major clinical guidelines (Cano-Martínez et al, 2020;Deroissart et al, 2021;Dubey et al, 1993;Lee et al, 2012). While hepatotoxicity and bone marrow toxicity can often be managed by dose reduction or temporary discontinuation of the drug, managing nausea and other GI side effects is more challenging.…”