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Immunotherapy for Atherosclerosis

Monaco, Claudia ; McNamara, Coleen A. ; Slütter, Bram ; Foks, Amanda C. ; Bekiranov, Stefan ; Mulder, Willem J.M. ; Mulder, Willem J.M. ; Goncalves, Isabel LU orcid and Lutgens, Esther (2025) In Physiological Reviews 105(4). p.2141-2230
Abstract

Cardiovascular disease is the global number one causeof mortality and morbidity. The majority of cardio vascular diseases are caused by atherosclerosis, a lipid-driven, inflammatory disease of the middle- and large-sized arteries. The disease is characterized by the formation of atherosclerotic plaques throughout the arterial tree. Over the years, insights intohe pathogenesis of atherosclerosis have shifted from a “lipid-driven” model to a “response-to-injury” perspective and more recently to a “lipid-driven inflammatory disease” viewpoint.We are now aware that a network of multiple immune cell types andsubsets of the innate and adaptive immune system inhabit our arteries. Intricate interactions between these immune cell subsets,... (More)

Cardiovascular disease is the global number one causeof mortality and morbidity. The majority of cardio vascular diseases are caused by atherosclerosis, a lipid-driven, inflammatory disease of the middle- and large-sized arteries. The disease is characterized by the formation of atherosclerotic plaques throughout the arterial tree. Over the years, insights intohe pathogenesis of atherosclerosis have shifted from a “lipid-driven” model to a “response-to-injury” perspective and more recently to a “lipid-driven inflammatory disease” viewpoint.We are now aware that a network of multiple immune cell types andsubsets of the innate and adaptive immune system inhabit our arteries. Intricate interactions between these immune cell subsets, nonimmune cells, and local environmental substances such as lipids, cell debris, and calcium cause a fluidic balance ofproinflammatory and regulatory responses. A dysregulationof this balance toward a proinflammatory milieu drives atherosclerotic disease progression. Although we have acknowl edged that atherosclerosis is an inflammatory disease, state-of-the-art treatments are still based on lipid lowering, antihypertensive, and lifestyle-changing strategies. In the past decade, clinical phase I, II, and III trials targeting the immune systemrevealed that patients tolerate immunotherapy, show decreased inflam mation, and/or have a reduction in cardiovascular endpoints.However, the search for novel immunothera peutic targetsand treatment regimens as well as stratification of patients who would benefit fromsuch treatments to combat atheroscleroticcardiovascular disease is only just beginning. In this review article, we will highlight the newest insights on the different cellsubsets and components of the immune system in atherosclerosisand elaborate on current and future immunotherapeuticsto treatatherosclerotic cardio vascular disease.

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author
; ; ; ; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
atherosclerosis, cardiovascular disease, immunology, immunotherapy, inflammation
in
Physiological Reviews
volume
105
issue
4
pages
90 pages
publisher
American Physiological Society
external identifiers
  • scopus:105009939049
  • pmid:40397615
ISSN
0031-9333
DOI
10.1152/physrev.00016.2024
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 the American Physiological Society.
id
17a5767a-370e-453e-8008-9f6a935a5b11
date added to LUP
2026-01-26 14:34:30
date last changed
2026-01-27 14:18:36
@article{17a5767a-370e-453e-8008-9f6a935a5b11,
  abstract     = {{<p>Cardiovascular disease is the global number one causeof mortality and morbidity. The majority of cardio vascular diseases are caused by atherosclerosis, a lipid-driven, inflammatory disease of the middle- and large-sized arteries. The disease is characterized by the formation of atherosclerotic plaques throughout the arterial tree. Over the years, insights intohe pathogenesis of atherosclerosis have shifted from a “lipid-driven” model to a “response-to-injury” perspective and more recently to a “lipid-driven inflammatory disease” viewpoint.We are now aware that a network of multiple immune cell types andsubsets of the innate and adaptive immune system inhabit our arteries. Intricate interactions between these immune cell subsets, nonimmune cells, and local environmental substances such as lipids, cell debris, and calcium cause a fluidic balance ofproinflammatory and regulatory responses. A dysregulationof this balance toward a proinflammatory milieu drives atherosclerotic disease progression. Although we have acknowl edged that atherosclerosis is an inflammatory disease, state-of-the-art treatments are still based on lipid lowering, antihypertensive, and lifestyle-changing strategies. In the past decade, clinical phase I, II, and III trials targeting the immune systemrevealed that patients tolerate immunotherapy, show decreased inflam mation, and/or have a reduction in cardiovascular endpoints.However, the search for novel immunothera peutic targetsand treatment regimens as well as stratification of patients who would benefit fromsuch treatments to combat atheroscleroticcardiovascular disease is only just beginning. In this review article, we will highlight the newest insights on the different cellsubsets and components of the immune system in atherosclerosisand elaborate on current and future immunotherapeuticsto treatatherosclerotic cardio vascular disease.</p>}},
  author       = {{Monaco, Claudia and McNamara, Coleen A. and Slütter, Bram and Foks, Amanda C. and Bekiranov, Stefan and Mulder, Willem J.M. and Mulder, Willem J.M. and Goncalves, Isabel and Lutgens, Esther}},
  issn         = {{0031-9333}},
  keywords     = {{atherosclerosis; cardiovascular disease; immunology; immunotherapy; inflammation}},
  language     = {{eng}},
  number       = {{4}},
  pages        = {{2141--2230}},
  publisher    = {{American Physiological Society}},
  series       = {{Physiological Reviews}},
  title        = {{Immunotherapy for Atherosclerosis}},
  url          = {{http://dx.doi.org/10.1152/physrev.00016.2024}},
  doi          = {{10.1152/physrev.00016.2024}},
  volume       = {{105}},
  year         = {{2025}},
}