Die uniforme Reaktion des Immunsystems auf Verletzungen besteht
in einer kaskadenartigen Freisetzung von Zytokinen. Diese führen
dann zur Rekrutierung von Granulozyten, Lymphozyten und Monozyten.
Die lokale Reaktion wird von einer systemischen Reaktion, der Akutphase-Reaktion,
begleitet. Erst in den letzten Jahren hat sich gezeigt, dass diese
Mechanismen auch in der Pathogenese der Atherosklerose eine entscheidende
Rolle spielen.
Die atherogenen Mechanismen in der Gefäßwand
umfassen Wechselwirkungen zwischen B- und T-Lymphozyten, Makrophagen
und den Zellen der Gefäßwand, vor allem Endothelzellen
und Gefäßwandmyozyten. Die Kommunikation der Leukozyten
untereinander und mit den Parenchymzellen erfolgt über
Transmitter wie Zytokine, Chemokine und Adhäsionsmoleküle.
Zytokine wirken im Gegensatz zu Hormonen vorwiegend lokal, die Signalübertragung
erfolgt über spezifische Rezeptoren. Zytokine haben nach
heutigem Erkenntnisstand wichtige Funktionen bei Entwicklung und
Progression der Atherosklerose, akutem Koronarsyndrom, Restenose, Herzinsuffizienz
und Transplantatabstoßung.
Die vorliegende Arbeit soll einen Überblick über
den aktuellen Kenntnisstand hinsichtlich der Bedeutung von Zytokinen in
der Pathogenese der Atherosklerose und der koronaren Herzerkrankung
vermitteln. Die Vielzahl der Publikationen zu diesen Thema machte
es jedoch erforderlich, eine enge Auswahl zu treffen. Einige Substanzen
mit zytokinähnlichen Wirkungen wie Platelet-derived growth
factor wurden wegen ihrer Bedeutung in diesem Kontext miteinbezogen.
Zur besseren Verständlichkeit wurde eine glossarische Übersicht
der Zytokine an den Anfang der Arbeit gestellt. Fettgedruckte Zytokine
sind im Glossar detailliert beschrieben.
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