Plenary speakers in the spotlight: Hansson and Pasterkamp

Professor Gerard Pasterkamp

UNDERSTANDING THE VULNERABLE PLAQUE – BASIS FOR TREATMENT OPTIONS

Gerard Pasterkamp is Professor of Experimental Cardiology, Division Heart and Lungs, University Medical Centre Utrecht (UMCU), The Netherlands. His research has focused on arterial remodelling in atherosclerotic disease. He is the initiator and project leader of Athero-Express BioBank Studies, a longitudinal atherosclerotic plaque biobank from more than 2,000 patients.

Identifying individuals at risk of plaque rupture and subsequent clinical events remains a clinical challenge, given the limitations of risk stratification based on traditional markers and histological characteristics of the vulnerable plaque.

The Athero-Express project aims to identify novel local plaque markers, specifically genetic and molecular markers, that will aid in identification of individuals at risk. The premise underlying this approach is that atherosclerosis is a systemic disease and therefore all plaques in the vascular system provide information about the stability of the atherosclerotic lesions irrespective of their location.

Proteomic studies show that local plaque proteins may have strong predictive value for future cardiovascular events in all vascular territories. Subsequent research will aim to improve risk prediction by combining multiple biomarkers to define a plaque protein signature. Novel imaging techniques using specific targeting of cell surface receptors may help in ultimately translating study findings to the primary prevention setting.

Systems biology approaches, incorporating clinical, genetic and molecular data from such large bio-bank studies, are likely to have therapeutic application, especially in the context of a personalised management approach.

Key references

1. Peeters W, Moll FL, Vink A, van der Spek PJ, de Kleijn DP, de Vries JP, Verheijen JH, Newby AC, Pasterkamp G. Collagenase matrix metalloproteinase-8 expressed in atherosclerotic carotid plaques is associated with systemic cardiovascular outcome. Eur Heart J 2011;32:2314-25.

2. Herder C, Peeters W, Illig T, et al. RANTES/CCL5 and risk for coronary events: results from the MONICA/KORA Augsburg case-cohort, Athero-Express and CARDIoGRAM studies. PLoS One 2011;6:e25734.

3. Ylä-Herttuala S, Bentzon JF, Daemen M et al. Stabilisation of atherosclerotic plaques. Position paper of the European Society of Cardiology (ESC) Working Group on atherosclerosis and vascular biology. Thromb Haemost 2011;106:1-19.

Forrás: The European Atherosclerosis Society website