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Title of Journal: Wien Klin Wochenschr

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Abbravation: Wiener klinische Wochenschrift

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Springer Vienna

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DOI

10.1016/0008-8749(88)90293-6

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1613-7671

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The role of inflammation in the pathophysiology of

Authors: Hannes F Alber Alois Suessenbacher Franz Weidinger
Publish Date: 2005/07/01
Volume: 117, Issue: 13-14, Pages: 445-455
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Abstract

All stages of atherosclerotic plaques are characterized by an inflammatory component in which T lymphocytes and macrophages orchestrate lesion progression and destabilization by releasing cytokines eg interferonγ tumor necrosis factorα tissue factor At the extreme end of this process plaque rupture occurs which may manifest clinically as an acute coronary syndrome Hence measuring this atherosclerosisinherent inflammation may help predicting cardiovascular events Accordingly different soluble inflammatory markers were studied for their predictive value in acute coronary syndromes Special attention was paid to highsensitivity Creactive protein hsCRP and soluble CD40 ligand sCD40L The latter seems not only to be a marker of inflammation and platelet activation but is suggested to directly destabilize atherosclerotic plaques by stimulating proinflammatory T lymphocytes Therefore reduction of soluble inflammatory markers is an attractive target for future therapeutic strategies Statins and glycoprotein IIb/IIIa antagonists wellestablished treatments in acute coronary syndromes were demonstrated to decrease hsCRP and sCD40L Whether this reduction translates into a better prognosis has to be investigated in further studiesDie Entstehung und Progression atherosklerotischer Plaques geht mit einer GefäßwandInflammation einher TLymphozyten und Makrophagen stellen die zelluläre Grundlage dieser Entzündung dar Durch Freisetzen verschiedener Zytokine zB Interferonγ TumorNekroseFaktorα Tissue Faktor tragen TLymphozyten und Makrophagen zum Plaquewachstum und schlussendlich zur Plaqueruptur bei Letztere kann sich klinisch als akutes Koronarsyndrom präsentieren Verschiedene lösliche Entzündungsstoffe inflammatorische Marker wurden in Bezug auf ihren prädiktiven Wert bei akuten Koronarsyndromen untersucht Dem hochsensitiven Creaktiven Protein hsCRP und dem löslichen CD40 Liganden sCD40L wurde dabei besonderes Interesse gezollt Letzterer scheint dabei nicht nur ein Marker zu sein sondern auch kausal als vorwiegend von aktivierten Thrombozyten stammendes proinflammatorisches TLymphozyten stimulierendes Molekül eine Rolle bei der Destabilisierung atherosklerotischer Läsionen zu spielen Die medikamentöse Therapie akuter Koronarsyndrome schließt die Behandlung mit Statinen und Glykoprotein IIb/IIIa Antagonisten ein Von beiden konnte gezeigt werden dass sie das hsCRP und den sCD40L im Blut von Patienten reduzieren Ob das auch mit einer verbesserten Prognose einhergeht ist noch nicht endgültig geklärt


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