Immune Modulation as a Therapeutic Strategy for Atherosclerosis

Coronary artery disease remains a major cause of death globally despite the introduction of novel therapeutics. Experimental evidences in the past decade have proved beyond doubt that innate and adaptive immune responses play an important and complex role in atherosclerosis, contributing to both atheroprotective and proatherogenic effects. The reduction of atherosclerotic lesions in animal models upon immunization with modified low-density lipoproteins has made the development and use of an atheroprotective vaccine a real possibility. Previous studies have used antigenic epitopes including oxidized phopholipid molecules, modified apolipoprotein B-100 (ApoB) peptide, cholesteryl ester transfer protein, heat shock proteins and vascular endothelial growth factor receptor to develop a vaccine for atherosclerosis. In our vaccine development effort, we have identified novel peptide epitopes from self-antigens and pathogens, which have shown promise in preliminary studies. In this review, we discuss the current approaches used for developing an atherosclerosis vaccine and the potential mechanisms of protection afforded by these immunomodulating agents.