Shedding light on inflammation

Inflammation is known to be important for progression and disruption of atherosclerotic plaque1 as well as being a key determinant of the biological response by the arterial wall to stent placement.2 Macrophage-mediated cytokine and proteolytic activity are key drivers in both scenarios3,4 and therefore represent biologically plausible targets for therapy as well as for molecular imaging, which may significantly improve prediction of major adverse cardiovascular events arising from de novo atherosclerotic lesions or following stent placement. Furthermore, such modalities may be beneficial for the preclinical and clinical evaluation of the efficacy of local and systemic therapies aimed at reducing inflammation. Calfon Press et al. 5 have reported an interesting proof of concept study, which tests this paradigm. They aimed to evaluate whether everolimus eluting stent (EES) implantation reduced local inflammation compared with bare metal stenting in a rabbit model of atherosclerosis induced by balloon injury and cholesterol feeding. Stent placement was targeted to plaques using intra-vascular ultrasound (IVUS) guidance and paired angiographic landmarks. The investigators used in vivo through blood near infrared fluorescence (NIRF) imaging. In contrast to previous work by this group6 and others7 in which lipid-laden macrophages were imaged after administration of indocyanin green, in this study, imaging was performed after administration of the NIRF agent …