Identifying the anti-inflammatory response to lipid lowering therapy: a position paper from the working group on atherosclerosis and vascular biology of the European Society of Cardiology.

Abstract

Dysregulated lipid metabolism induces an inflammatory and immune response leading to atherosclerosis. Conversely, inflammation may alter lipid metabolism. Recent treatment strategies in secondary prevention of atherosclerosis support beneficial effects of both anti-inflammatory and lipid-lowering therapies beyond current targets. There is a controversy about the possibility that anti-inflammatory effects of lipid-lowering therapy may be either independent or not of a decrease in low-density lipoprotein cholesterol. In this Position Paper, we critically interpret and integrate the results obtained in both experimental and clinical studies on anti-inflammatory actions of lipid-lowering therapy and the mechanisms involved. We highlight that: (i) besides decreasing cholesterol through different mechanisms, most lipid-lowering therapies share anti-inflammatory and immunomodulatory properties, and the anti-inflammatory response to lipid-lowering may be relevant to predict the effect of treatment, (ii) using surrogates for both lipid metabolism and inflammation as biomarkers or vascular inflammation imaging in future studies may contribute to a better understanding of the relative importance of different mechanisms of action, and (iii) comparative studies of further lipid lowering, anti-inflammation and a combination of both are crucial to identify effects that are specific or shared for each treatment strategy.

• Authors: José Tuñón, Lina Badimón, Marie-Luce Bochaton-Piallat, Bertrand Cariou, Mat J Daemen, Jesus Egido, Paul C Evans, Imo E Hoefer, Daniel F J Ketelhuth, Esther Lutgens, Christian M Matter, Claudia Monaco, Sabine Steffens, Erik Stroes, Cécile Vindis, Christian Weber, Magnus Bäck
• Journal: Cardiovascular research (Cardiovasc Res) Vol. 115 Issue 1 Pg. 10-19 (01 01 2019) ISSN: 1755-3245 [Electronic] England
• PMID: 30534957 (Publication Type: Journal Article, Practice Guideline, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Anti-Inflammatory Agents
• Biomarkers
• Hypolipidemic Agents
• Inflammation Mediators
• Lipids
• PCSK9 Inhibitors
• Serine Proteinase Inhibitors
• PCSK9 protein, human
• Proprotein Convertase 9

Topics

• Animals
• Anti-Inflammatory Agents (therapeutic use)
• Atherosclerosis (blood, drug therapy, epidemiology, immunology)
• Biomarkers (blood)
• Dyslipidemias (blood, drug therapy, epidemiology, immunology)
• Humans
• Hypolipidemic Agents (therapeutic use)
• Inflammation (blood, drug therapy, epidemiology, immunology)
• Inflammation Mediators (blood)
• Lipids (blood)
• PCSK9 Inhibitors
• Proprotein Convertase 9 (metabolism)
• Risk Factors
• Serine Proteinase Inhibitors (therapeutic use)
• Treatment Outcome