Mechanisms of Vascular Inflammation and Potential Therapeutic Targets: A Position Paper From the ESH Working Group on Small Arteries

Francisco J Rios¹, Carolina de Ciuceis², Georgios Georgiopoulos³, Antonios Lazaridis⁴, Ryszard Nosalski^{5

6}, George Pavlidis^{7

8}, Simon Tual-Chalot⁹, Claudia Agabiti-Rosei², Livia L Camargo¹, Edyta Dąbrowska¹⁰, Fosca Quarti-Trevano¹¹, Marcin Hellmann¹², Stefano Masi^{13

14}, Mariarosaria Lopreiato¹⁴, Georgios Mavraganis³, Alessandro Mengozzi^{14

15

16}, Augusto C Montezano¹, Konstantinos Stavropoulos¹⁷, Pawel J Winklewski¹⁸, Jacek Wolf¹⁰, Sarah Costantino¹⁹, Michael Doumas¹⁰, Eugenia Gkaliagkousi⁴, Guido Grassi¹¹, Tomasz J Guzik^{5

6}, Ignatios Ikonomidis^{7

8}, Krzysztof Narkiewicz¹⁰, Francesco Paneni^{15

19

20}, Damiano Rizzoni^{2

21}, Kimon Stamatelopoulos³, Konstantinos Stellos^{9

22

23

24}, Stefano Taddei¹⁴, Rhian M Touyz¹, Agostino Virdis¹⁴

Affiliations

¹ Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada (F.J.R., L.L.C., A.C.M., R.M.T.).
² Department of Clinical and Experimental Sciences, University of Brescia (C.d.C., C.A.-R., D.R.).
³ Angiology and Endothelial Pathophysiology Unit, Department of Clinical Therapeutics, Medical School (G.G., G.M., K. Stamatelopoulos), National and Kapodistrian University of Athens.
⁴ Third Department of Internal Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, Greece (A.L., E.G.).
⁵ Centre for Cardiovascular Sciences; Queen's Medical Research Institute, University of Edinburgh, United Kingdom (R.N., T.J.G.).
⁶ Department of Internal Medicine, Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland (R.N., T.J.G.).
⁷ Medical School (G.P., I.I.), National and Kapodistrian University of Athens.
⁸ Preventive Cardiology Laboratory and Clinic of Cardiometabolic Diseases, 2-Cardiology Department, Attikon Hospital, Athens, Greece (G.P., I.I.).
⁹ Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, United Kingdom (S.T.-C., K. Stellos).
¹⁰ Department of Hypertension and Diabetology, Center of Translational Medicine (E.D., J.W., K.N.) and M.D.).
¹¹ Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy (F.Q.-T., G.G.).
¹² Cardiac Diagnostics (M.H.), Medical University of Gdansk, Poland.
¹³ Institute of Cardiovascular Science, University College London, United Kingdom (S.M.).
¹⁴ Department of Clinical and Experimental Medicine, University of Pisa, Italy (S.M., M.L., A.M., S.T., A.V.).
¹⁵ Center for Translational and Experimental Cardiology, Department of Cardiology, University Hospital Zurich, University of Zurich, Switzerland (A.M., F.P.).
¹⁶ Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa (A.M.).
¹⁷ Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, Greece (K. Stavropoulos).
¹⁸ Departments of Human Physiology (P.J.W.), Medical University of Gdansk, Poland.
¹⁹ University Heart Center (S.C., F.P.), University Hospital Zurich, Switzerland.
²⁰ Department of Research and Education (F.P.), University Hospital Zurich, Switzerland.
²¹ Division of Medicine, Spedali Civili di Brescia, Italy (D.R.).
²² Department of Cardiovascular Research, European Center for Angioscience, Medical Faculty Mannheim (K. Stellos), Heidelberg University, Germany.
²³ Department of Cardiology, University Hospital Mannheim (K. Stellos), Heidelberg University, Germany.
²⁴ German Centre for Cardiovascular Research, Heidelberg/Mannheim Partner Site (K. Stellos).

PMID: 38511317
DOI: 10.1161/HYPERTENSIONAHA.123.22483

Mechanisms of Vascular Inflammation and Potential Therapeutic Targets: A Position Paper From the ESH Working Group on Small Arteries

Francisco J Rios et al. Hypertension. 2024 Jun.

. 2024 Jun;81(6):1218-1232.

doi: 10.1161/HYPERTENSIONAHA.123.22483. Epub 2024 Mar 21.

Authors

Affiliations

¹ Research Institute of the McGill University Health Centre, McGill University, Montreal, Canada (F.J.R., L.L.C., A.C.M., R.M.T.).
² Department of Clinical and Experimental Sciences, University of Brescia (C.d.C., C.A.-R., D.R.).
³ Angiology and Endothelial Pathophysiology Unit, Department of Clinical Therapeutics, Medical School (G.G., G.M., K. Stamatelopoulos), National and Kapodistrian University of Athens.
⁴ Third Department of Internal Medicine, Aristotle University of Thessaloniki, Papageorgiou Hospital, Greece (A.L., E.G.).
⁵ Centre for Cardiovascular Sciences; Queen's Medical Research Institute, University of Edinburgh, United Kingdom (R.N., T.J.G.).
⁶ Department of Internal Medicine, Center for Medical Genomics OMICRON, Jagiellonian University Medical College, Krakow, Poland (R.N., T.J.G.).
⁷ Medical School (G.P., I.I.), National and Kapodistrian University of Athens.
⁸ Preventive Cardiology Laboratory and Clinic of Cardiometabolic Diseases, 2-Cardiology Department, Attikon Hospital, Athens, Greece (G.P., I.I.).
⁹ Biosciences Institute, Vascular Biology and Medicine Theme, Faculty of Medical Sciences, Newcastle University, United Kingdom (S.T.-C., K. Stellos).
¹⁰ Department of Hypertension and Diabetology, Center of Translational Medicine (E.D., J.W., K.N.) and M.D.).
¹¹ Clinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy (F.Q.-T., G.G.).
¹² Cardiac Diagnostics (M.H.), Medical University of Gdansk, Poland.
¹³ Institute of Cardiovascular Science, University College London, United Kingdom (S.M.).
¹⁴ Department of Clinical and Experimental Medicine, University of Pisa, Italy (S.M., M.L., A.M., S.T., A.V.).
¹⁵ Center for Translational and Experimental Cardiology, Department of Cardiology, University Hospital Zurich, University of Zurich, Switzerland (A.M., F.P.).
¹⁶ Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa (A.M.).
¹⁷ Second Medical Department, Hippokration Hospital, Aristotle University of Thessaloniki, Greece (K. Stavropoulos).
¹⁸ Departments of Human Physiology (P.J.W.), Medical University of Gdansk, Poland.
¹⁹ University Heart Center (S.C., F.P.), University Hospital Zurich, Switzerland.
²⁰ Department of Research and Education (F.P.), University Hospital Zurich, Switzerland.
²¹ Division of Medicine, Spedali Civili di Brescia, Italy (D.R.).
²² Department of Cardiovascular Research, European Center for Angioscience, Medical Faculty Mannheim (K. Stellos), Heidelberg University, Germany.
²³ Department of Cardiology, University Hospital Mannheim (K. Stellos), Heidelberg University, Germany.
²⁴ German Centre for Cardiovascular Research, Heidelberg/Mannheim Partner Site (K. Stellos).

PMID: 38511317
DOI: 10.1161/HYPERTENSIONAHA.123.22483

Abstract

Inflammatory responses in small vessels play an important role in the development of cardiovascular diseases, including hypertension, stroke, and small vessel disease. This involves various complex molecular processes including oxidative stress, inflammasome activation, immune-mediated responses, and protein misfolding, which together contribute to microvascular damage. In addition, epigenetic factors, including DNA methylation, histone modifications, and microRNAs influence vascular inflammation and injury. These phenomena may be acquired during the aging process or due to environmental factors. Activation of proinflammatory signaling pathways and molecular events induce low-grade and chronic inflammation with consequent cardiovascular damage. Identifying mechanism-specific targets might provide opportunities in the development of novel therapeutic approaches. Monoclonal antibodies targeting inflammatory cytokines and epigenetic drugs, show promise in reducing microvascular inflammation and associated cardiovascular diseases. In this article, we provide a comprehensive discussion of the complex mechanisms underlying microvascular inflammation and offer insights into innovative therapeutic strategies that may ameliorate vascular injury in cardiovascular disease.

Keywords: blood pressure; cardiovascular diseases; hypertension; inflammation; microcirculation.

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Disclosures None.

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Mechanisms of Vascular Inflammation and Potential Therapeutic Targets: A Position Paper From the ESH Working Group on Small Arteries

Affiliations

Mechanisms of Vascular Inflammation and Potential Therapeutic Targets: A Position Paper From the ESH Working Group on Small Arteries

Authors

Affiliations

Abstract

Conflict of interest statement

MeSH terms

LinkOut - more resources

Full Text Sources