Das Komplementsystem

Summary

Atherosclerotic diseases such as coronary artery disease and ischaemic stroke are caused by chronic inflammation in arterial vessel walls. The complement system is part of the innate immune system. It is involved in many processes contributing to onset and development of atherosclerotic plaques up to the final stage of acute thrombotic events. This is due to its prominent role in inflammatory processes. In addition, there is increasing evidence that interactions between complement and coagulation provide a link between inflammation and thrombosis. On the other hand, the complement system also has an atheroprotective function through the clearance of apoptotic material.

The knowledge of these complex mechanisms will become increasingly important, also for clinicians, since it may lead to novel therapeutic and diagnostic options. Therapies targeting the complement system have the potential to reduce tissue damage caused by acute ischaemic events. Whether early anti-inflammatory and anti-complement therapy may be able to prevent atherosclerosis, remains a hot topic for research.

Zusammenfassung

Atherosklerotisch bedingte Erkrankungen wie koronare Herzkrankheit und ischämischer Schlaganfall sind pathogenetisch auf eine chronische Entzündung in arteriellen Gefäßwänden zurückzuführen. Das Komplementsystem als Teil der angeborenen Immunabwehr ist sowohl für die Entstehung, als auch für die fortschreitende Entwicklung der entzündlichen Plaques bis hin zum Endstadium der Atherothrombose von Bedeutung. Dies ist einerseits begründet in seiner prominenten Rolle bei Entzündungsprozessen; doch es gibt auch immer mehr Evidenz dafür, dass Interaktionen zwischen Komplementsystem und Blutgerinnung eine Verbindung zwischen Entzündung und Thrombose darstellen. Die Rolle des Komplements ist aber keinesfalls nur proatherogen. Aufgrund seiner Beteiligung bei der Beseitigung von apoptotischem Material wird dem Komplementsystem auch eine atheroprotektive Funktion zugeschrieben.

Die Kenntnis dieser komplexen Zusammenhänge wird auch für Kliniker an Bedeutung zunehmen, da sich in Zukunft neue therapeutische und diagnostische Möglichkeiten eröffnen können. Gegen das Komplementsystem gerichtete Therapien haben das Potenzial, die Schäden akuter ischämischer Ereignisse zu vermindern. Ob eine frühzeitige antiinflammatorische und Anti-Komplement-Therapie bereits die Entstehung der Atherosklerose aufhalten kann, bleibt weiter zu erforschen.

Keywords

Complement - inflammation - atherosclerosis - cardiovascular disease - cerebrovascular disease

Schlüsselwörter

Komplementsystem - Entzündung - Athero - sklerose - kardiovaskuläre Erkrankungen - zerebro vaskuläre Erkrankungen

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