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Current Challenges and Advances in Atherosclerosis
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Current Challenges and Advances in Atherosclerosis

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiovascular Medicine".

Deadline for manuscript submissions: closed (25 February 2024) | Viewed by 24759

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Dr. Tomoaki Ishigami

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Guest Editor
Department of Medical Science and Cardio-Renal Medicine, Graduate School of Medicine, Yokohama City University, Fukuura 3-9, Kanazawa-ku, Yokohama, Japan
Interests: atherosclerosis; inflammation; antigen; antibodies; auto-antibodies; interleukin 5; B1 cell; B2 cell; spleen; tertiary lymphoid tissue
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Atherosclerosis is a phenomenon which is of major interest in both basic science and clinical medicine in order to achieve healthy longevity worldwide. Atherosclerosis generally develops without any signs and symptoms, eventually resulting in various kinds of catastrophic cardiovascular events, such as ischemic heart disease, ischemic stroke, and rupture of major vessel aneurysm. Scientists working on the biological aspects of atherosclerosis have recently focused on the inflammation seen in vessel walls from intimal to adventitial tissues. However, although inflammation is indeed a dominant pathological phenomenon in atherosclerosis, it has been recognized that there is no simple answer to the question of whether inflammation promotes or retards atherosclerosis. Atherosclerosis is a complex disease that involves several different cell types, such as lymphocytes, macrophages, monocytes, dendric cells, and their molecular products. Chronic inflammation in atherosclerosis might be accompanied with basical immunological changes, including auto-immune disorders. For example, recent studies have shown that multiple auto-antibodies are found in the sera of the subjects with atherosclerosis via inventory high-throughput auto-antibody screening techniques using cell-free technologies. Nevertheless, the immune system is even more complicated, with many cell types, hundreds of cytokines, and literally millions of different antigens. This Special Issue, titled “Current Challenges and Advances in Atherosclerosis”, will focus on recent challenges and advances in the field of atherosclerosis by global expert scientists and clinicians to elucidate the complicated features of atherosclerosis and translational attempts for medical–clinical frontiers.

All papers submitted to this Special Issue are reviewed by independent referees, and the final decision is made by a JCM Editorial Board Member who does not have any conflicts of interest with the submission.

Dr. Tomoaki Ishigami
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • atherosclerosis
  • inflammation
  • antigen
  • antibodies
  • auto-antibodies
  • B cell
  • T cell
  • tertiary lymphoid tissue

Published Papers (12 papers)

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Research

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12 pages, 270 KiB  
Article
An Evaluation of Plasma TNF, VEGF-A, and IL-6 Determination as a Risk Marker of Atherosclerotic Vascular Damage in Early-Onset CAD Patients
by Marta Bialecka, Michał Rac, Violetta Dziedziejko, Krzysztof Safranow, Dariusz Chlubek and Monika Ewa Rać
J. Clin. Med. 2024, 13(6), 1742; https://doi.org/10.3390/jcm13061742 - 18 Mar 2024
Viewed by 484
Abstract
Background: The pathogenesis of atherosclerosis is multifactorial and diverse. Pro-inflammatory cytokines are involved in these processes. It is suggested that inflammation may represent a novel and modifiable risk factor for cardiovascular disease. Therefore, this study aimed to gain insight into the relationship [...] Read more.
Background: The pathogenesis of atherosclerosis is multifactorial and diverse. Pro-inflammatory cytokines are involved in these processes. It is suggested that inflammation may represent a novel and modifiable risk factor for cardiovascular disease. Therefore, this study aimed to gain insight into the relationship between plasma concentrations of TNF, VEGF, IL-6, and radiological parameters of atherosclerosis progression in patients with early-onset coronary artery disease (CAD). Methods: Seventy clinically stable patients were included in the study group. The age range for men was no more than 50 years, while for women, it was no more than 55 years. Fasting blood samples were obtained for plasma TNF, VEGF, and IL-6 protein measurements. Plasma cytokine concentrations were measured via ELISA. Doppler ultrasound of the carotid and peripheral arteries was performed in all patients. Results: After Bonferroni correction, there were no significant correlations between any cytokine and radiological parameters of atherosclerosis progression in our patients. Conclusions: The determination of plasma TNF, IL-6, and VEGF levels may not be a reliable marker for the vascular condition, and the measurement of these cytokines in plasma cannot replace the classical radiological examination of the vessels. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
10 pages, 1510 KiB  
Article
Upper-Arm SBP Decline Associated with Repeated Cuff-Oscillometric Inflation Significantly Correlated with the Arterial Stiffness Index
by Noriyuki Kawaura, Rie Nakashima-Sasaki, Hiroshi Doi, Kotaro Uchida, Takuya Sugawara, Sae Saigo, Kaito Abe, Kentaro Arakawa, Koichi Tamura, Kiyoshi Hibi and Tomoaki Ishigami
J. Clin. Med. 2022, 11(21), 6455; https://doi.org/10.3390/jcm11216455 - 31 Oct 2022
Cited by 1 | Viewed by 1119
Abstract
We evaluated the clinical significance of the new non-invasive vascular indices to explore their potential utility using repeated cuff-oscillometric inflation. In 250 consecutive outpatients, we performed a cross-sectional, retrospective, single-center, observational study to investigate sequential differences in arterial stiffness using blood pressure, arterial [...] Read more.
We evaluated the clinical significance of the new non-invasive vascular indices to explore their potential utility using repeated cuff-oscillometric inflation. In 250 consecutive outpatients, we performed a cross-sectional, retrospective, single-center, observational study to investigate sequential differences in arterial stiffness using blood pressure, arterial velocity pulse index (AVI), and arterial pressure volume index (API) with repeated measurements. Males accounted for 62.7% of the patients, and the mean age was 68.1 ± 12.1 years. The mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the first reading in repeated measurements were 133.07 ± 21.20 mmHg and 73.94 ± 13.56 mmHg, respectively. The mean AVI and API were 23.83 ± 8.30 and 31.12 ± 7.86, respectively. In each measurement of these parameters, although DBP and AVI did not show significant changes throughout repeated measurements, SBP and API decreased significantly according to the measurement orders. Furthermore, changes in SBP and API were significantly correlated in several of the models. In this study, it was concluded that upper-arm SBP decline associated with repeated cuff-oscillometric inflation was significantly correlated with the arterial stiffness index. The findings of this study will allow clinicians to easily recognize the progression of atherosclerosis through regular, routine practice. In conclusion, this study suggests that changes in repeated SBP measurements may be predictive of arterial stiffness and atherosclerosis. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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12 pages, 752 KiB  
Article
The Prognostic Value of Cardiac Troponin I in Patients with or without Three-Vessel Disease Undergoing Complete Percutaneous Coronary Intervention
by Zhi-Fan Li, Shuang Zhang, Hui-Wei Shi, Wen-Jia Zhang, Yong-Gang Sui, Jian-Jun Li, Ke-Fei Dou, Jie Qian and Na-Qiong Wu
J. Clin. Med. 2022, 11(13), 3896; https://doi.org/10.3390/jcm11133896 - 04 Jul 2022
Viewed by 1597
Abstract
Postprocedural cardiac troponin I (cTnI) elevation commonly occurs in patients undergoing percutaneous coronary intervention (PCI); however, its prognostic value remains controversial. This study aimed to investigate the prognostic value of peak postprocedural cTnI in cardiac patients with or without three-vessel disease (TVD) undergoing [...] Read more.
Postprocedural cardiac troponin I (cTnI) elevation commonly occurs in patients undergoing percutaneous coronary intervention (PCI); however, its prognostic value remains controversial. This study aimed to investigate the prognostic value of peak postprocedural cTnI in cardiac patients with or without three-vessel disease (TVD) undergoing complete PCI. A total of 1237 consecutive patients (77% males, mean age 58 ± 10 years) with normal baseline cTnI levels were enrolled, 439 patients (77% males, 59 ± 10 years) with TVD, and 798 patients (77% males, 57 ± 10 years) with single- or double-vessel disease (non-TVD). The primary outcome was the occurrence of major adverse cardiovascular events (MACE), defined as a composite of non-fatal MI, non-fatal stroke, unplanned revascularization, re-hospitalization due to heart failure or severe arrhythmias, and all-cause death. During the median follow-up of 5.3 years, a total of 169 patients (13.7%) developed MACE, including 73 (16.6%) in the TVD group and 96 (12.0%) in the non-TVD group (p = 0.024). After adjustment, the multivariate Cox analysis showed that hypertension (HR 1.50; 95% CI: 1.01–2.20; p = 0.042), TVD (HR 1.44; 95% CI: 1.03–2.02; p = 0.033), and cTnI ≥ 70× URL (HR 2.47; 95% CI: 1.28–4.78, p = 0.007) were independently associated with increased MACE during long-term follow-up. Further subgroup analyses showed that cTnI ≥ 70× URL was an independent predictor of MACE in TVD patients (HR 3.32, 95% CI: 1.51–7.34, p = 0.003), but not in non-TVD patients (HR 1.01, 95%CI: 0.24–4.32, p = 0.991). In conclusion, elevation of post-PCI cTnI ≥ 70× URL is independently associated with a high risk of MACE during long-term follow-up in patients with TVD, but not in those with non-TVD. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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10 pages, 2763 KiB  
Article
Vascular Alterations Preceding Arterial Wall Thickening in Overweight and Obese Children
by Sung-Ai Kim, Kyung Hee Park, Sarah Woo, Yoon Myung Kim, Hyun Jung Lim and Woo-Jung Park
J. Clin. Med. 2022, 11(12), 3520; https://doi.org/10.3390/jcm11123520 - 19 Jun 2022
Cited by 3 | Viewed by 1363
Abstract
Background: Childhood obesity is linked to adverse cardiovascular outcomes in adulthood. This study aimed to assess the impact of childhood obesity on the vasculature and to investigate whether vascular alteration precedes arterial wall thickening in childhood. Methods: A total of 295 overweight (body [...] Read more.
Background: Childhood obesity is linked to adverse cardiovascular outcomes in adulthood. This study aimed to assess the impact of childhood obesity on the vasculature and to investigate whether vascular alteration precedes arterial wall thickening in childhood. Methods: A total of 295 overweight (body mass index [BMI] 85th to 95th percentile, n = 30) and obese (BMI ≥ 95th percentile, n = 234) children aged 7–17 years and 31 normal-weight controls with similar age and gender were prospectively recruited. We assessed anthropometric data and laboratory findings, and measured the carotid intima–media thickness (IMT), carotid artery (CA) diameter, M-mode-derived arterial stiffness indices, and velocity vector imaging parameters, including the CA area, fractional area change, circumferential strain, and circumferential strain rate (SR). Results: The mean ± standard deviation age of the participants was 10.8 ± 2.1 years; 172 (58%) children were male. Regarding structural properties, there was no difference in the IMT between the three groups. The CA diameter was significantly increased in obese children, whereas the CA area showed a significant increase beginning in the overweight stage. Regarding functional properties, contrary to β stiffness and Young’s elastic modulus, which were not different between the three groups, the circumferential SR showed a significant decrease beginning in the overweight stage and was independently associated with BMI z-scores after adjusting for covariates. Conclusion: We have demonstrated that arterial stiffening and arterial enlargement precede arterial wall thickening, and that these vascular alterations begin at the overweight stage in middle childhood or early adolescence. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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14 pages, 1678 KiB  
Article
Increased Plasma Levels of Myosin Heavy Chain 11 Is Associated with Atherosclerosis
by Lisa Takahashi, Tomoaki Ishigami, Hirofumi Tomiyama, Yuko Kato, Hiroyuki Kikuchi, Koichiro Tasaki, Jun Yamashita, Shigeru Inoue, Masataka Taguri, Toshitaka Nagao, Taishiro Chikamori, Yoshihiro Ishikawa and Utako Yokoyama
J. Clin. Med. 2021, 10(14), 3155; https://doi.org/10.3390/jcm10143155 - 16 Jul 2021
Cited by 1 | Viewed by 1968
Abstract
Many studies have revealed numerous potential biomarkers for atherosclerosis, but tissue-specific biomarkers are still needed. Recent lineage-tracing studies revealed that smooth muscle cells (SMCs) contribute substantially to plaque formation, and the loss of SMCs causes plaque vulnerability. We investigated the association of SMC-specific [...] Read more.
Many studies have revealed numerous potential biomarkers for atherosclerosis, but tissue-specific biomarkers are still needed. Recent lineage-tracing studies revealed that smooth muscle cells (SMCs) contribute substantially to plaque formation, and the loss of SMCs causes plaque vulnerability. We investigated the association of SMC-specific myosin heavy chain 11 (myosin-11) with atherosclerosis. Forty-five patients with atherosclerosis and 34 control subjects were recruited into our study. In the atherosclerosis patients, 35 patients had either coronary artery disease (CAD) or peripheral artery disease (PAD), and 10 had both CAD and PAD. Coronary arteries isolated from five patients were subjected to histological study. Circulating myosin-11 levels were higher in the CAD or PAD group than in controls. The area under the receiver operating characteristic curve of myosin-11 was 0.954. Circulating myosin-11 levels in the CAD and PAD group were higher than in the CAD or PAD group, while high-sensitivity C-reactive protein concentrations did not differ between these groups. Multinomial logistic regression analyses showed a significant association of myosin-11 levels with the presence of multiple atherosclerotic regions. Myosin-11 was expressed in the medial layer of human atherosclerotic lesions where apoptosis elevated. Circulating myosin-11 levels may be useful for detecting spatial expansion of atherosclerotic regions. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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10 pages, 1520 KiB  
Article
Associations between High-Density Lipoprotein Functionality and Major Adverse Cardiovascular Events in Patients Who Have Undergone Coronary Computed Tomography Angiography
by Hiroko Inoue, Yuhei Shiga, Kenji Norimatsu, Kohei Tashiro, Makito Futami, Yasunori Suematsu, Makoto Sugihara, Hiroaki Nishikawa, Yousuke Katsuda and Shin-ichiro Miura
J. Clin. Med. 2021, 10(11), 2431; https://doi.org/10.3390/jcm10112431 - 30 May 2021
Cited by 3 | Viewed by 1920
Abstract
The present study aimed to investigate the associations between high-density lipoprotein (HDL) functionality and major adverse cardiovascular events (MACE) in patients who have undergone coronary computed tomography angiography (CCTA). We performed a prospective cohort study and enrolled 151 patients who underwent CCTA and [...] Read more.
The present study aimed to investigate the associations between high-density lipoprotein (HDL) functionality and major adverse cardiovascular events (MACE) in patients who have undergone coronary computed tomography angiography (CCTA). We performed a prospective cohort study and enrolled 151 patients who underwent CCTA and had a follow-up of up to 5 years. We measured cholesterol efflux capacity (CEC), caspase-3/7 activity and monocyte chemoattractant protein-1 (MCP-1) secretion as bioassays of HDL functionality. The patients were divided into MACE(−) (n = 138) and MACE(+) (n = 13) groups. While there was no significant difference in %CEC, caspase-3/7 activity or MCP-1 secretion between the MACE(−) and MACE(+) groups, total CEC and HDL cholesterol (HDL-C) in the MACE(+) group were significantly lower than those in the MACE(−) group. Total CEC was correlated with HDL-C. A receiver-operating characteristic curve analysis showed that there was no significant difference between the areas under the curves for total CEC and HDL-C. In conclusion, total CEC in addition to HDL-C, but not %CEC, was associated with the presence of MACE. On the other hand, HDL functionality with regard to anti-inflammatory and anti-apoptosis effects was not associated with MACE. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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11 pages, 582 KiB  
Article
Impact of Isolated High Home Systolic Blood Pressure and Diabetic Nephropathy in Patients with Type 2 Diabetes Mellitus: A 5-Year Prospective Cohort Study
by Nobuko Kitagawa, Noriyuki Kitagawa, Emi Ushigome, Hidetaka Ushigome, Isao Yokota, Naoko Nakanishi, Masahide Hamaguchi, Mai Asano, Masahiro Yamazaki and Michiaki Fukui
J. Clin. Med. 2021, 10(9), 1929; https://doi.org/10.3390/jcm10091929 - 29 Apr 2021
Cited by 3 | Viewed by 1556
Abstract
Background: A previous 2-year cohort study has shown that isolated high home systolic blood pressure (IH-HSBP) may increase the risk of diabetic nephropathy, using normal HBP as a reference. However, this association has not been previously assessed in the medium to long term. [...] Read more.
Background: A previous 2-year cohort study has shown that isolated high home systolic blood pressure (IH-HSBP) may increase the risk of diabetic nephropathy, using normal HBP as a reference. However, this association has not been previously assessed in the medium to long term. Methods: This prospective 5-year cohort study of 424 patients, with normal or mildly increased albuminuria, investigated the effect of IH-HSBP on the risk of diabetic nephropathy in patients with type 2 diabetes mellitus. Diabetic nephropathy was defined as an advancement from normal or mildly increased albuminuira to moderate or severely increased albuminuria. Results: Among 424 patients, 75 developed diabetic nephropathy during the study period. The adjusted odds ratio for developing diabetic nephropathy given IH-HSBP was 2.39 (95% confidence interval, 1.15–4.96, p = 0.02). The odds ratio for developing nephropathy in patients with IH-HSBP younger than 65 years was higher than that in patients with IH-HSBP older than 65 years. Conclusion: IH-HSBP was associated with an increased risk of diabetic nephropathy among type 2 diabetes mellitus patients with normal or mildly increased albuminuria in the medium to long term. The results support and strengthen previous reports. These findings suggest that IH-HSBP might be a useful marker in disease prognostication. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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7 pages, 2193 KiB  
Article
Home-Measured Blood Pressure Is Associated with Handgrip Strength in Patients with Type 2 Diabetes: The KAMOGAWA-HBP Study
by Tomonori Kimura, Emi Ushigome, Yoshitaka Hashimoto, Naoko Nakanishi, Masahide Hamaguchi, Mai Asano, Masahiro Yamazaki and Michiaki Fukui
J. Clin. Med. 2021, 10(9), 1913; https://doi.org/10.3390/jcm10091913 - 28 Apr 2021
Viewed by 1416
Abstract
The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type [...] Read more.
The association between blood pressure measured at home and handgrip strength in patients with diabetes has not been investigated. Therefore, in this study, we aimed to assess this association among patients with type 2 diabetes. In this cross-sectional study, 157 patients with type 2 diabetes underwent muscle tests and morning and evening blood-pressure measurements at home in triplicate for 14 consecutive days throughout the study period. Univariate and multivariate regression analyses were conducted to analyze the relationship between home blood-pressure parameters and handgrip strength. The average age and hemoglobin A1c of the patients were 70.5 years and 7.1%, respectively. Morning diastolic blood pressure of [β (95% confidence interval; CI): 0.20 (0.03, 0.37)] was associated with handgrip strength in men, while morning systolic blood pressure of [−0.09 (−0.15, −0.04)], morning pulse pressure of [−0.14 (−0.21, −0.08)], and evening pulse pressure of [−0.12 (−0.19, −0.04)] were associated with handgrip strength in women. Home-measured blood pressure was associated with handgrip strength. Sex differences were found in the relationship between home blood-pressure parameters and handgrip strength. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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Review

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17 pages, 2010 KiB  
Review
Circular RNA as Therapeutic Targets in Atherosclerosis: Are We Running in Circles?
by Jeffrey Triska, Christo Mathew, Yang Zhao, Yuqing E. Chen and Yochai Birnbaum
J. Clin. Med. 2023, 12(13), 4446; https://doi.org/10.3390/jcm12134446 - 02 Jul 2023
Cited by 1 | Viewed by 1105
Abstract
Much attention has been paid lately to harnessing the diagnostic and therapeutic potential of non-coding circular ribonucleic acids (circRNAs) and micro-RNAs (miRNAs) for the prevention and treatment of cardiovascular diseases. The genetic environment that contributes to atherosclerosis pathophysiology is immensely complex. Any potential [...] Read more.
Much attention has been paid lately to harnessing the diagnostic and therapeutic potential of non-coding circular ribonucleic acids (circRNAs) and micro-RNAs (miRNAs) for the prevention and treatment of cardiovascular diseases. The genetic environment that contributes to atherosclerosis pathophysiology is immensely complex. Any potential therapeutic application of circRNAs must be assessed for risks, benefits, and off-target effects in both the short and long term. A search of the online PubMed database for publications related to circRNA and atherosclerosis from 2016 to 2022 was conducted. These studies were reviewed for their design, including methods for developing atherosclerosis and the effects of the corresponding atherosclerotic environment on circRNA expression. Investigated mechanisms were recorded, including associated miRNA, genes, and ultimate effects on cell mechanics, and inflammatory markers. The most investigated circRNAs were then further analyzed for redundant, disparate, and/or contradictory findings. Many disparate, opposing, and contradictory effects were observed across experiments. These include levels of the expression of a particular circRNA in atherosclerotic environments, attempted ascertainment of the in toto effects of circRNA or miRNA silencing on atherosclerosis progression, and off-target, cell-specific, and disease-specific effects. The high potential for detrimental and unpredictable off-target effects downstream of circRNA manipulation will likely render the practice of therapeutic targeting of circRNA or miRNA molecules not only complicated but perilous. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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17 pages, 911 KiB  
Review
Effects of SGLT2 Inhibitors on Atherosclerosis: Lessons from Cardiovascular Clinical Outcomes in Type 2 Diabetic Patients and Basic Researches
by Jing Xu, Taro Hirai, Daisuke Koya and Munehiro Kitada
J. Clin. Med. 2022, 11(1), 137; https://doi.org/10.3390/jcm11010137 - 27 Dec 2021
Cited by 18 | Viewed by 4720
Abstract
Atherosclerosis-caused cardiovascular diseases (CVD) are the leading cause of mortality in type 2 diabetes mellitus (T2DM). Sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective oral drugs for the treatment of T2DM patients. Multiple pre-clinical and clinical studies have indicated that SGLT2 inhibitors not only [...] Read more.
Atherosclerosis-caused cardiovascular diseases (CVD) are the leading cause of mortality in type 2 diabetes mellitus (T2DM). Sodium-glucose cotransporter 2 (SGLT2) inhibitors are effective oral drugs for the treatment of T2DM patients. Multiple pre-clinical and clinical studies have indicated that SGLT2 inhibitors not only reduce blood glucose but also confer benefits with regard to body weight, insulin resistance, lipid profiles and blood pressure. Recently, some cardiovascular outcome trials have demonstrated the safety and cardiovascular benefits of SGLT2 inhibitors beyond glycemic control. The SGLT2 inhibitors empagliflozin, canagliflozin, dapagliflozin and ertugliflozin reduce the rates of major adverse cardiovascular events and of hospitalization for heart failure in T2DM patients regardless of CVD. The potential mechanisms of SGLT2 inhibitors on cardioprotection may be involved in improving the function of vascular endothelial cells, suppressing oxidative stress, inhibiting inflammation and regulating autophagy, which further protect from the progression of atherosclerosis. Here, we summarized the pre-clinical and clinical evidence of SGLT2 inhibitors on cardioprotection and discussed the potential molecular mechanisms of SGLT2 inhibitors in preventing the pathogenesis of atherosclerosis and CVD. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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20 pages, 1405 KiB  
Review
Recent Advances on the Role and Therapeutic Potential of Regulatory T Cells in Atherosclerosis
by Toru Tanaka, Naoto Sasaki and Yoshiyuki Rikitake
J. Clin. Med. 2021, 10(24), 5907; https://doi.org/10.3390/jcm10245907 - 16 Dec 2021
Cited by 5 | Viewed by 3098
Abstract
Atherosclerotic diseases, including ischemic heart disease and stroke, are a main cause of mortality worldwide. Chronic vascular inflammation via immune dysregulation is critically involved in the pathogenesis of atherosclerosis. Accumulating evidence suggests that regulatory T cells (Tregs), responsible for maintaining immunological tolerance and [...] Read more.
Atherosclerotic diseases, including ischemic heart disease and stroke, are a main cause of mortality worldwide. Chronic vascular inflammation via immune dysregulation is critically involved in the pathogenesis of atherosclerosis. Accumulating evidence suggests that regulatory T cells (Tregs), responsible for maintaining immunological tolerance and suppressing excessive immune responses, play an important role in preventing the development and progression of atherosclerosis through the regulation of pathogenic immunoinflammatory responses. Several strategies to prevent and treat atherosclerosis through the promotion of regulatory immune responses have been developed, and could be clinically applied for the treatment of atherosclerotic cardiovascular disease. In this review, we summarize recent advances in our understanding of the protective role of Tregs in atherosclerosis and discuss attractive approaches to treat atherosclerotic disease by augmenting regulatory immune responses. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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10 pages, 547 KiB  
Review
The Types and Proportions of Commensal Microbiota Have a Predictive Value in Coronary Heart Disease
by Lin Chen, Tomoaki Ishigami, Hiroshi Doi, Kentaro Arakawa and Kouichi Tamura
J. Clin. Med. 2021, 10(14), 3120; https://doi.org/10.3390/jcm10143120 - 15 Jul 2021
Cited by 8 | Viewed by 2155
Abstract
Previous clinical studies have suggested that commensal microbiota play an important role in atherosclerotic cardiovascular disease; however, a synthetic analysis of coronary heart disease (CHD) has yet to be performed. Therefore, we aimed to investigate the specific types of commensal microbiota associated with [...] Read more.
Previous clinical studies have suggested that commensal microbiota play an important role in atherosclerotic cardiovascular disease; however, a synthetic analysis of coronary heart disease (CHD) has yet to be performed. Therefore, we aimed to investigate the specific types of commensal microbiota associated with CHD by performing a systematic review of prospective observational studies that have assessed associations between commensal microbiota and CHD. Of the 544 published articles identified in the initial search, 16 publications with data from 16 cohort studies (2210 patients) were included in the analysis. The combined data showed that Bacteroides and Prevotella were commonly identified among nine articles (n = 13) in the fecal samples of patients with CHD, while seven articles commonly identified Firmicutes. Moreover, several types of commensal microbiota were common to atherosclerotic plaque and blood or gut samples in 16 cohort studies. For example, Veillonella, Proteobacteria, and Streptococcus were identified among the plaque and fecal samples, whereas Clostridium was commonly identified among blood and fecal samples of patients with CHD. Collectively, our findings suggest that several types of commensal microbiota are associated with CHD, and their presence may correlate with disease markers of CHD. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Atherosclerosis)
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