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To mark the 20th anniversary of Nature Reviews Cardiology, we bring together a Focus issue on atheroimmunology, highlighting the importance and our growing understanding of the contribution of innate and adaptive immune mechanisms to the pathogenesis of atherosclerosis. The Focus features five Review articles discussing various aspects of atheroimmunology, including the roles of the complement system and efferocytosis, the link between autoimmune disease and atherosclerosis, and potential therapeutic strategies using specialized pro-resolving mediators or targeting immune cell recruitment in atherosclerosis.
The immune response is not unlike a game of chess, with white and black pieces playing opposing roles and orchestrating an opening, a middle and an endgame of innate immunity, adaptive immunity and resolution, respectively. After decades of research, the study of atheroimmunology has brought the first therapeutics to the clinic. Can we resynchronize the immune system in atherosclerosis and save the king?
In this Review, Kemper and colleagues discuss the canonical and non-canonical roles of the complement system in the pathogenesis of atherosclerosis and discuss potential new therapeutic strategies targeting the complement system for the prevention and treatment of atherosclerotic cardiovascular disease.
In this Review, Adkar and Leeper describe the mechanisms of programmed cell death and efferocytosis, discuss how efferocytosis becomes impaired in atherosclerosis and other cardiometabolic diseases, and suggest potential strategies to target these pathways for the treatment of atherosclerotic cardiovascular disease.
In this Review, Porsch and Binder discuss the evidence for and mechanisms of the increased and premature risk of atherosclerotic cardiovascular disease in patients with autoimmune disease, with particular focus on systemic lupus erythematosus and rheumatoid arthritis.
In this Review, Fredman and Serhan discuss the role of specialized pro-resolving mediators, a superfamily of endogenous signalling lipids that mediate resolution of inflammation processes in atherosclerosis, and appraise the therapeutic potential of specialized pro-resolving mediators for the prevention and treatment of atherosclerosis, and the resolution of uncontrolled vascular inflammation.
In this Review, the authors discuss the receptors, ligands and interactors that regulate immune cell recruitment in atherosclerosis, describe mechanisms that promote the resolution of inflammation in atherosclerotic lesions, and highlight potential strategies to target these pathways for the treatment of atherosclerotic cardiovascular disease.