Drug-induced immunomodulation to affect the development and progression of atherosclerosis: a new opportunity?

Abstract

Inflammation and cytokine pathways are crucial for the development and progression of atherosclerotic lesions. In this review, the hypothesis that immunomodulatory drugs provide a possible therapeutic modality for cardiovascular disease is evaluated. Therefore, after a short overview of the specific inflammatory pathways involved in atherosclerosis, literature on the effect of several immunomodulatory drugs, such as nonsteroidal anti-inflammatory drugs, specific cyclooxygenase inhibitors and immunosuppressive drugs, used currently in the prevention of rejection after organ transplant, on the development and progression of atherosclerosis is reviewed. In addition, the pleiotropic immunomodulatory effect of two established cardiovascular drugs (angiotensin-converting enzyme inhibitors and statins) is discussed.

Keywords::

• atherosclerosis
• coronary artery disease
• COX-1/COX-2 inhibition
• cyclosporine A
• inflammation
• mycophenolate mofetil
• sirolimus
• tacrolimus

Acknowledgement

Sylvia Heeneman and Mat Daemen are involved in the European Vascular Genomics Network (grant LSHM-CT-2003–503254.).