Zytokine in der Pathogenese der Atherosklerose

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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