Endothelial dysfunction as a possible link between C-reactive protein levels and cardiovascular disease

Nevner at lavgrads betennelse er utgangspunktet for arterosklerose. Og at det hemmer endotelfunksjonen, altså blodkar cellenes evne til å trekke seg sammen og utvide seg.

http://www.clinsci.org/cs/098/0531/cs0980531.htm

«Low-grade chronic inflammation, characterized by elevated plasma concentrations of C-reactive protein (CRP), is associated with an increased risk of atherosclerotic cardiovascular disease.»

«These data demonstrate for the first time a relationship between low-grade chronic inflammation and basal endothelial NO synthesis (measured using an invasive method), and support the notion that endothelial dysfunction is a critical intermediate phenotype in the relationship between inflammation and cardiovascular disease.»

«Inflammation may increase cardiovascular risk via effects on known cardiovascular risk factors (e.g. lipid profiles), by altering other putative risk markers (e.g. fibrinogen, plasminogen activator inhibitor-1), or by impairing carbohydrate metabolism [2]. «

«In this clinical study we provide, to the best of our knowledge, the first direct evidence for an association between endothelial dysfunction and low-grade chronic inflammation. »

Viser til at blodkar får vansker med å slappe av når det er betennelsesfaktorer tilstedet:
«Our data also complement previous experiments by Bhagat et al. [6,7], who noted that infusion of endotoxin or pro-inflammatory cytokines [interleukin-1, tumour necrosis factor-a (TNF-a)] into superficial hand veins of healthy volunteers (provoking a local acute inflammatory response) caused a selective impairment of endothelium-dependent relaxation. «

«Correlation does not imply causality, but the relationship we have suggested between inflammation and endothelial dysfunction is biologically plausible. Low-grade chronic vascular inflammation may promote biochemical (e.g. peroxidative) and cellular changes in the vessel wall.»

Viser at NO produksjonen synker ved betennelse og gjør at blodet lettere levrer seg, som videre øker sjansen for sammentrekning, trombose og full avstengning av blodkar.
«A decrease in basal NO production secondary to low-grade chronic inflammation would favour increased expression of cell-surface adhesion molecules for leucocytes and platelets, promote interaction between these cells and the vascular endothelium, and induce procoagulant activity. Such effects, in turn, might increase the likelihood of vasospasm, thrombosis and vessel occlusion [1]. Thus endothelial dysfunction may be a critical factor in the relationship between low-grade chronic inflammation and cardiovascular disease.»

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