Aggeliki Kotsiafti, Dimitris Eleutheriou, Stella Stabouli
Atherosclerosis, a highly prevalent disease in the adult population, presents constantly increasing rates in the pediatric population. Data from recent studies correlate atherosclerosis with autoimmune mechanisms. The role of Th17, Treg, IL-6, PAF, reinforce this position. The role of autoimmunity is clear both in the pathophysiology of atherogenesis, as well as in the treatment effect of statins as drugs of choice. The aim of this review was to highlight the autoimmune model of atherosclerosis. The pathophysiology of atherosclerosis, as well as the mechanisms of action of statins in the treatment of atherosclerosis, including their pleiotropic effects, are described. LDL is known to play an important role in the pathophysiology of atherogenesis. The oxidized form of LDL, the oxLDL, leads to uncontrolled production of Platelet-Activating Factor. Moreover, the entrance of oxidized LDL in the subendothelial space results to the formation of “foam cells”. Statins cause reduction of LDL- cholesterol in the serum, but also exhibit anti-inflammatory and immunomodulatory effects reducing the production of proinflammatory cytokines secreted by T cells and antigen-presenting cells.
Keywords: atherosclerosis, “foam cells”, oxLDL, Tregs, Th17, statins, IL-16