Leukotrienes as Biomarkers of Cardiovascular Disease

Abstract

Myocardial infarction and stroke are major causes of morbidity and mortality and result from an underlying atherosclerosis of the coronary and cerebrovascular vasculature. Atherosclerotic plaques are a site of lipid accumulation and chronic inflammation. There is a need for novel biomarkers to predict an individual's cardiovascular risk, and several inflammatory biomarkers have been explored for their prognostic value. Leukotrienes are lipid mediators of inflammation, which are formed in atherosclerotic lesions and participate in the atherosclerosis process. The local production of leukotrienes leads to high levels in atherosclerotic plaques, whereas circulating levels are negligible and difficult to measure. Ex vivo stimulation of leukocytes reflects the leukotriene synthesizing capacity and the leukotriene B-4 levels released from granulocytes in response to calcium inophore are associated with echographic measures of carotid artery vascular remodeling. Urinary leukotriene E-4 is a validated biomarker of asthma, and is increased in coronary artery disease. Salivary levels of leukotriene B-4 were recently associated with vascular stiffness and subclinical atherosclerosis. Leukotriene measures have in addition been associated with several cardiovascular risk factors, such as smoking, diabetes, obesity, and obstructive sleep apnea. The present chapter reviews the available literature using these different approaches for evaluating leukotrienes as biomarkers for cardiovascular disease.