The role of the NLRP3 inflammasome in atherosclerotic disease: Systematic review and meta-analysis

IF 2.5 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of cardiology Pub Date : 2024-03-22 DOI:10.1016/j.jjcc.2024.03.003
Marina Khair MBBS , Mark Khair BSc , Venkat N. Vangaveti PhD , Usman H. Malabu MBBS, MSc
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Abstract

Atherosclerosis is a chronic, progressive cardiovascular disease characterized by cholesterol deposition within blood vessel walls. Recent literature has suggested that the NLRP3 [NOD (nucleotide oligomerization domain)-, LRR (leucine-rich repeat)-, and PYD (pyrin domain)-containing protein 3] inflammasome is a key mediator in the development, progression, and destabilization of atherosclerotic plaques. This review aims to evaluate the current literature on the role of NLRP3 in human atherosclerosis.

This systematic review was registered on the PROSPERO database (ID = CRD42022340039) and involved the search of a total of 8 databases. Records were screened in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A total of 20 studies were included and quality assessed using the NIH: NHLBI tool. Six were eligible for meta-analysis using RevMan 5.4.1.

We identified 20 relevant articles representing 3388 participants. NLRP3 mRNA levels and downstream cytokines, interleukin (IL)-1β and IL-18 were found to be associated with atherosclerotic disease. Fold changes in NLRP3 mRNA levels were most strongly associated with high risk atherosclerotic disease, compared to controls [0.84 (95 % CI: 0.41–1.28)]. IL-1β mRNA fold change was more robustly associated with high-risk atherosclerotic disease [0.61 (95 % CI: 0.10–1.13)] than IL-18 [0.47 (95 % CI: 0.02–0.91)].

NLRP3, IL-1β, and IL-18 are associated with high-risk atherosclerotic disease. However, given the scope of this review, the role of this inflammasome and its cytokine counterparts in acting as prognosticators of coronary artery disease severity is unclear. Several upstream activators such as cholesterol crystals are involved in the canonical or non-canonical activation of the NLRP3 inflammasome and its downstream cytokines. These findings highlight the necessity for further research to delineate the exact mechanisms of NLRP3 inflammasome activation and potential drug targets.

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NLRP3炎性体在动脉粥样硬化疾病中的作用:系统综述和荟萃分析。
动脉粥样硬化是一种以胆固醇在血管壁沉积为特征的慢性、进行性心血管疾病。最近的文献表明,NLRP3 [NOD(核苷酸寡聚化结构域)-、LRR(富亮氨酸重复)- 和PYD(含吡啶结构域)-蛋白 3]炎性体是动脉粥样硬化斑块发生、发展和不稳定的关键介质。本综述旨在评估目前有关 NLRP3 在人类动脉粥样硬化中作用的文献。本系统综述在 PROSPERO 数据库(ID = CRD42022340039)中注册,共检索了 8 个数据库。根据系统综述和元分析首选报告项目(PRISMA)指南对记录进行了筛选。共纳入 20 项研究,并使用 NIH:NHLBI工具进行质量评估。其中六项符合使用 RevMan 5.4.1 进行荟萃分析的条件。我们确定了代表 3388 名参与者的 20 篇相关文章。研究发现,NLRP3 mRNA水平及下游细胞因子、白细胞介素(IL)-1β和IL-18与动脉粥样硬化疾病有关。与对照组相比,NLRP3 mRNA水平的折叠变化与高风险动脉粥样硬化性疾病的关系最为密切[0.84(95 % CI:0.41-1.28)]。与 IL-18 [0.47 (95 % CI: 0.02-0.91)] 相比,IL-1β mRNA 的折叠变化与高风险动脉粥样硬化性疾病的相关性更强[0.61 (95 % CI: 0.10-1.13)]。NLRP3、IL-1β和IL-18与高风险动脉粥样硬化性疾病有关。然而,鉴于本综述的范围,这种炎性体及其对应细胞因子在冠状动脉疾病严重程度的预后中的作用尚不清楚。胆固醇晶体等几种上游激活剂参与了 NLRP3 炎性体及其下游细胞因子的规范或非规范激活。这些发现凸显了进一步研究NLRP3炎症小体激活的确切机制和潜在药物靶点的必要性。
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来源期刊
Journal of cardiology
Journal of cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.90
自引率
8.00%
发文量
202
审稿时长
29 days
期刊介绍: The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.
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