靶向抑制炎症反应防治心血管疾病-CANTOS与CIRT研究背景和意义  

Targeted inhibition of inflammation in cardiovascular disease

作　　者：李大主[1] 何少林[1] 

机构地区：[1]华中科技大学附属协和医院心内科武汉,430022

出　　处：《临床心血管病杂志》2014年第1期1-2,共2页Journal of Clinical Cardiology

摘　　要：炎症反应在动脉粥样硬化(AS)相关疾病的发生发展中起重要作用,然而直接抑制炎症反应是否可减少冠心病患者心血管事件的发生,尚不明确。低剂量甲氨蝶呤(LDM)或白细胞介素(IL)-1β抑制剂———康纳单抗只抑制炎症反应,对血脂及血小板功能等影响较小。CIRT和CANTOS研究将在全世界纳入25 000例以上的患者,采用随机对照双盲的方法探讨LDM(CIRT)或康纳单抗(CANTOS)是否可减少炎症反应持续存在的稳定性冠心病患者心脏事件、卒中及心血管相关死亡的发生。如果研究结果阳性,则不仅验证了AS炎症假说,而且将为心血管疾病二级预防及新发糖尿病提供全新治疗方案。Inflammation plays a fundamental role in atherosclerosis.Yet,whether direct inhibition of inflammation will reduce the occurrence of adverse cardiovascular outcomes is unkown.Low-dose methotrexate（LDM）,or canakinumab（a monoclonal antihuman IL-1β antibody）could reduce several inflammatory biomarkers without substantive effects on lipid levels,hemostasis,and platelet function.CANTOS and CIRT trails will enroll more than 25,000 patients worldwide.Each trial uses an event-driven protocol to address whether IL-1inhibition with canakinumab（CANTOS）or LDM（CIRT）can reduce rates of recurrent myocardial infarction,stroke,and cardiovascular death as compared to placebo in stable coronary artery disease patients with a persistent pro-inflammatory response（in CIRT using the additional entry criteria of the presence of either diabetes or metabolic syndrome and in CANTOS using the additional entry criteria of hs-CRP 2mg/L）.Together,both trials would support the inflammatory hypothesis of atherosclerosis and serve as catalyst for the development of novel therapeutic agents focused specifically on vascular inflammation.

关 键 词：动脉粥样硬化 炎性反应 CANTOS CIRT 

分 类 号：R543.1[医药卫生—心血管疾病]