Inflammation in pathogenesis of cardiovascular diseases and prospects for targeted anti-inflammatory therapy

Chronic inflammation is an independent risk factor of atherosclerosis and cardiovascular diseases (CVD). The initiator of this process is innate immune response through activation of pro-inflammatory cytokines — interleukin-1β (IL-1β) and interleukin-6 (IL-6). This review discusses current concepts of the role of inflammation in pathogenesis of atherosclerosis, focusing on IL-6 signaling pathways, its soluble receptor (sIL-6R) and glycoprotein 130 (gp130), as well as of C-reactive protein (CRP) as clinical biomarker of inflammation. Evidence on the role of inflammation obtained from various studies is reviewed. Special attention is paid to prospects of targeted anti-inflammatory therapy, including inhibition of IL-1β pathway, global inhibition of IL-6, and selective blocking of its trans-signaling pathway using soluble gp130 (sgp130). This would likely suppress pathological inflammation in atherosclerosis while preserving cytokine’s important protective functions and will become a key objective of future research.