Atherosclerosis is a major human killer and non-resolving inflammation is a prime suspect

Cardiovasc Res. 2021 Nov 22;117(13):2563-2574. doi: 10.1093/cvr/cvab309.

Abstract

The resolution of inflammation (or inflammation-resolution) is an active and highly coordinated process. Inflammation-resolution is governed by several endogenous factors, and specialized pro-resolving mediators (SPMs) are one such class of molecules that have robust biological function. Non-resolving inflammation is associated with a variety of human diseases, including atherosclerosis. Moreover, non-resolving inflammation is a hallmark of ageing, an inevitable process associated with increased risk for cardiovascular disease. Uncovering mechanisms as to why inflammation-resolution is impaired in ageing and in disease and identifying useful biomarkers for non-resolving inflammation are unmet needs. Recent work has pointed to a critical role for balanced ratios of SPMs and pro-inflammatory lipids (i.e. leucotrienes and/or specific prostaglandins) as a key determinant of timely inflammation resolution. This review will focus on the accumulating findings that support the role of non-resolving inflammation and imbalanced pro-resolving and pro-inflammatory mediators in atherosclerosis. We aim to provide insight as to why these imbalances occur, the importance of ageing in disease progression, and how haematopoietic function impacts inflammation-resolution and atherosclerosis. We highlight open questions regarding therapeutic strategies and mechanisms of disease to provide a framework for future studies that aim to tackle this important human disease.

Keywords: Ageing; Atherosclerosis; Immunology; Inflammation; hematopoiesis.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / therapeutic use
  • Arteries / drug effects
  • Arteries / immunology*
  • Arteries / metabolism
  • Arteries / pathology
  • Atherosclerosis / drug therapy
  • Atherosclerosis / immunology*
  • Atherosclerosis / metabolism
  • Atherosclerosis / pathology
  • Cardiovascular Agents / therapeutic use
  • Humans
  • Immune System / drug effects
  • Immune System / immunology*
  • Immune System / metabolism
  • Inflammation / drug therapy
  • Inflammation / immunology*
  • Inflammation / metabolism
  • Inflammation / pathology
  • Inflammation Mediators / antagonists & inhibitors
  • Inflammation Mediators / immunology*
  • Inflammation Mediators / metabolism
  • Plaque, Atherosclerotic
  • Signal Transduction

Substances

  • Anti-Inflammatory Agents
  • Cardiovascular Agents
  • Inflammation Mediators