Summary
In consideration of the important role of inflammation in plaque progression and stability,
recent work has focused on whether plasma markers of inflammation can non-invasively
diagnose and predict coronary artery disease (CAD) and other forms of atherosclerotic
disorders. Although several studies support an important pathogenic role of chemokines
in atherogenesis and plaque destabilization, potentially representing attractive therapeutic
targets in atherosclerotic disorders,this does not necessarily mean that chemokines
are suitable parameters for risk prediction. In fact, the ability to reflect up-stream
inflammatory activity, stable levels in individuals and high stability of the actual
protein (e.g. long half-life and negligible circadian variation), are additional important
criteria for an ideal biomarker in cardiovascular disease. Although plasma/serum levels
of certain chemokines (e.g. interleukin 8 and monocyte chemoattractant protein- 1)
have been shown to be predictive for future cardiac events in some studies, independent
of traditional cardiovascular risk factors and C-reactive protein,and although certain
gene polymorphisms of chemokines/chemokine receptors (e.g. fractalkine receptor) have
been shown to be predictive of future atherosclerotic disease, further prospective
studies, including a larger number patients,are needed to make any firm conclusion.
While the demonstrations of an association between chemokines and CAD are a necessary
first step, such studies do not establish the full clinical utility of a biomarker,
which is a more demanding process that requires validation in multiple cohorts, and
clear demonstration of incremental prognostic value over traditional risk models.
If successful, such new biomarker will be a useful indicator for better risk assessment,diagnosis,and
prognosis, as well as monitoring pharmacological treatments for atherosclerosis.
Keywords
Chemokines - atherosclerosis - gene polymorphism - biomarkers - inflammation
