Leukotrienes in the atherosclerotic cardiovascular diseases — a systematic review

Abstract

Introduction:The role of inflammation in the pathogenesis of atherosclerotic diseases is strongly suggested. There are multiple studies indicating the possibility of a pathophysiological connection between atherosclerotic changes and leukotrienes (LTs) -the products of arachidonic acid metabolism. The goal of this systematic review, performed in line with the PRISMA statement, was to investigate the potential role of LTs in the pathophysiology of atherosclerotic cardiovascular diseases (CVD). Material and methods: The MEDLINE, EMBASE, and Cochrane Database of Systematic Reviews were searched to identify the potentially eligible studies. Publications that contained information on any type of LTs identified in blood or urine were included in the review. A database search identified 2082 records. Reliable LTs identification in patients with CVD was used in 30 publications. Results: Stable and acute forms of coronary artery disease are characterized by the overproduction of different types of LTs. The level of LTB 4 and LTC 4 in the blood is elevated in patients with cerebral ischemia. Patients with acute and chronic peripheral artery disease have elevated levels of LTE 4 in urine. Conclusions: The findings of this systematic review show that there is a clear tendency to indicate the association of cardiovascular atherosclerotic diseases with increased production of LTs. This dependency detailed characteristic remains unclear and the question on the impact of elevated leukotrienes on clinical atherosclerotic disease manifestations is still open.

Inflammatory Markers Used as Predictors of Subclinical Atherosclerosis in Patients with Diabetic Polyneuropathy

“…Recently, Wachsmann et al [ 74 , 75 ] emphasized the importance of diabetes control and HbA1C in the favorable evolution one year after endovascular treatment in patients diagnosed with critical limb ischemia; much more recently in 2022, they published a systematic review in which they demonstrated the role of leukotrienes in cardiovascular atherosclerotic pathology.…”

Atherosclerosis and Its Related Laboratory Biomarkers

“…Among the inflammatory markers studied in the context of atherosclerosis, Wachsmann-Maga et al explored the role of leukotrienes (LTs), suggesting the potential for a pathophysiological link between atherosclerotic alterations and products derived from the metabolism of arachidonic acid [70]. Leukotrienes (LTs) are highly potent biologically active compounds that play a role in various cellular processes and function as mediators of inflammation.…”

“…Leukotrienes (LTs) are highly potent biologically active compounds that play a role in various cellular processes and function as mediators of inflammation. They belong to the eicosanoid group, which are signaling molecules involved in inflammation [70]. LTs are produced as part of the metabolic pathway that oxidizes essential fatty acids, such as arachidonic acid (AA) and eicosatetraenoic acid (EPA), through the action of the enzyme arachidonate 5-lipoxygenase.…”

“…Notably, the levels of LTB4 and LTC4 in the blood are elevated in patients with cerebral ischemia. Similarly, patients with acute and chronic peripheral artery disease exhibit increased levels of LTE4 in their urine [70]. Furthermore, Maga P. et al conducted a study that showed how successive measurements of urinary leukotriene E4 could be used to anticipate the lack of success in angioplasty, whether performed with or without stent implantation, for peripheral artery occlusive disease [71].…”

“…This suggests a clear trend associating cardiovascular atherosclerotic diseases with heightened LT production. However, the precise nature of this relationship remains unclear, and the impact of elevated leukotrienes on clinical manifestations of atherosclerotic diseases is still a subject of ongoing investigation [70].…”