Toll-like receptor response in cardiovascular disease

Abstract

Atherosclerosis is considered an inflammatory disease of the arterial wall that involves activation of leukocytes. The full mechanism of leukocyte activation is unclear, but is in part attributed to stimulation of Toll-like receptors (TLRs) that are expressed on the surface of immune competent cells. TLRs recognize exogenous and endogenous ligands and are capable of stimulating the cell to produce pro-inflammatory cytokines. The amount of cytokine that is produced upon TLR activation is called the TLR response. In this thesis the TLR response is investigated in patients that undergo percutaneous coronary intervention, vascular surgery and diagnostic myocardial single photon emission computed tomography. The results of these studies indicate a TLR hyper-response in patients with severe atherosclerosis and signs of chronic ischemia and a TLR hypo-response following acute trauma and ischemia. These findings point to a role for TLRs in the management of atherosclerosis and related disease and can serve as an entry point for future therapy and diagnostic tools in this field.