C-reactive protein and interleukin-6 in vascular disease

Abstract

Recent advances in basic science have shown that atherosclerosis should be considered as a chronic inflammatory process, and that a pivotal role of inflammation is evident from initiation through progression and complication of atherosclerosis. In the past few years many studies have examined the potential for biochemical markers of inflammation to act as predictors of coronary heart disease (CHD) risk in a variety of clinical settings. Several large, prospective epidemiological studies have shown consistently that C-reactive protein (CRP) and interleukin-6 (IL-6) plasma levels are strong independent predictors of risk of future cardiovascular events, both in patients with a history of CHD and in apparently healthy subjects. These molecules could be useful to complement traditional risk factors, as well as to identify new categories of subjects prone to atherosclerosis development. An intriguing question is whether these inflammatory molecules simply represent sensitive markers of systemic inflammation or if they actively contribute to atherosclerotic lesion formation and instability. In this paper we will review the evidence concerning the cardiovascular prognostic value and the potential direct involvement of CRP and IL-6 in atherogenesis.

Association between carotid haemodynamics and inflammation in patients with essential hypertension

“…1,9 Inflammatory markers such as CRP and IL-6 not only participate in lesion formation but also in the plaque architecture that favours rupture. 7 A number of studies have shown that increased blood pressure has an important influence on elevated levels of circulating IL-6 4 and hs-CRP.…”

“…3 Indeed, hypertensive patients who were free from any other important medical conditions were reported to have high circulating levels of proinflammatory cytokines such as tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), 4 and C-reactive protein (CRP). 5,6 These cytokines may cause inflammation of the endothelium, 7,8 which can cause further damage to the endothelium 9 and the elevation of blood pressure. One of the most useful factors for estimating the inflammatory response and the risk for vascular events is high sensitive CRP (hs-CRP).…”

Genetic and environmental contributions to plasma C-reactive protein and interleukin-6 levels – a study in twins

“…[28][29][30] Thus, some authors proposed IL-6 as a useful prognostic marker of CVD outcome [31][32][33][34][35][36][37] and suggested a central role for IL-6 in the pathogenesis of CHD. [38][39][40] However, the estimated heritability for IL-6 ranged between 0.17 and 0.57 in the literature 16,41,42 and previous studies concerning the heritability of CRP and IL-6 have to be interpreted carefully (Table 1). The design and exact analysis differed (twin to general family studies, VogelMotulsky heritability to other variance composition methods) and the correction for possible confounders varied greatly between the studies (different confounders considered, different methods).…”

<b>Influência da periodontite apical nos níveis séricos de marcadores de Proteína C-reativa</b>: revisão da literatura.

“…É produzida e liberada pelos hepatócitos sendo a IL-6 a maior indutora de sua síntese, enquanto um papel menor está atribuído a outras citocinas como a IL-1 e o TNF-α (23). Dentre as propriedades pró-inflamatórias da CRP estão a sua capacidade de reconhecer e promover a fagocitose dos micro-organismos e das células agredidas no processo inflamatório; promover a ativação dos monócitos/macrófagos por aumentar a síntese e secreção de IL-1 e TNF-α e induzir a expressão de moléculas de adesão e secreção de IL-6 pelas células endoteliais (23).…”