Atherosclerosis - Underlying inflammatory mechanisms and clinical implications

Inflammation plays an important role in the initiation and progression of atherosclerosis but many of its underlying mechanisms remain to be explored. Atherosclerotic plaques which are more prone to destabilisation and rupture, leading to clinical events, are characterised by increased infiltration of leukocytes and other inflammatory mediators, compared with stable fibrotic plaques. T cell mediated responses, through expression of cytokines and chemokines, play an important role in the inflammatory process; and more recently potentially anti -inflammatory markers have also been identified. Current management involves both mechanical restoration of blood flow and pharmacotherapy aimed in part at suppressing the underlying inflammatory mechanisms. The aims of this review are to outline the pro- and anti-inflammatory processes in atherosclerosis, as well as their clinical implications. (C) 2007 Elsevier Ltd. All rights reserved.