Cytokines proinflammatoires et risque cardio-vasculaire : De l’infarctus du myocarde à la tempête cytokinique du Covid-19*

Miossec, Pierre

The mechanisms of inflammatory diseases involve the key inflammatory cytokines IL-1, TNF, IL-6, and IL-17 which are now therapeutic targets with biotherapies. They contribute to the local manifestations of clinically different diseases. In addition to these local aspects, these cytokines have systemic effects from their action on the liver, muscle, adipose tissue and the cardiovascular system. All these diseases have in common an increase in cardiovascular risk. In the general population, the same concepts are applicable, as shown by the link between an even modest rise in CRP and cardiovascular risk. More recently, the cytokine storm of severe forms of Covid-19 has shown that synergistic interactions between cytokines first described in vitro are further amplified in the clinical picture with multiple and severe impairment of key organs. In these chronic and acute contexts, control of inflammation by targeting cytokines is a new vascular treatment option, with already important results for IL-1.