Back to Journals » Vascular Health and Risk Management » Volume 15
Cholesterol-embolization syndrome: current perspectives
Authors Ozkok A
Received 7 February 2019
Accepted for publication 10 May 2019
Published 8 July 2019 Volume 2019:15 Pages 209—220
DOI https://doi.org/10.2147/VHRM.S175150
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Konstantinos Tziomalos
Abdullah Ozkok
Department of Internal Medicine and Nephrology, Memorial Şişli Hospital, Istanbul, Turkey
Abstract: Cholesterol-embolization syndrome (CES) is a multisystemic disease with various clinical manifestations. CES is caused by embolization of cholesterol crystals (CCs) from atherosclerotic plaques located in the major arteries, and is induced mostly iatrogenically by interventional and surgical procedures; however, it may also occur spontaneously. Embolized CCs lead to both ischemic and inflammatory damage to the target organ. Therefore, anti-inflammatory agents, such as corticosteroids and cyclophosphamide, have been investigated as treatment for CES in several studies, with conflicting results. Recent research has revealed that CES is actually a kind of autoinflammatory disease in which inflammasome pathways, such as NLRP3 and IL1, are induced by CCs. These recent findings may have clinical implications such that colchicine and IL1 inhibitors, namely canakinumab, may be beneficial in the early stages of CES.
Keywords: cholesterol crystals, atherosclerosis, inflammation, autoinflammation, corticosteroids, interleukin 1, NLRP3, colchicine, canakinumab
This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.
By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.