Recent advances in vascular inflammation: C-reactive protein and other inflammatory biomarkers

Inflammatory vascular diseases are initiated and perpetuated by the interaction of immune cells with cells of the affected vessel wall. This is directed by a network of chemical messengers, which, in a state of vascular health, exist as balanced but opposing forces. Our understanding of this highly complex process has advanced significantly in the last several decades. The detection of vascular inflammation and monitoring of this activity have long been attempted in systemic vasculitis, and, more recently, in atherosclerosis. Markers of vascular inflammation used thus far have been of limited value; few provide both adequate sensitivity and specificity for any particular disease. New insights into the pathophysiology of vascular inflammation have identified other potential markers that may improve detection and monitoring of these conditions.

Immunomodulatory mediators of the inflammatory cascade have been identified, and their roles are being defined. There are recent data that implicate various cytokines, proteases, adhesion molecules, and acute phase proteins as participants in the generation of vascular inflammation.

The pursuit of highly sensitive and specific markers of vascular inflammation has produced a wealth of information that has been instrumental in advancing our comprehension of this complex process. Further studies will establish the role of these new markers in the diagnosis, monitoring, and prognostication of inflammatory vascular disease.