Interleukin-1 Revisited Further Insights Into its Role in Atherosclerosis and as a Potential Therapeutic Target for Treatment

Stable obstructive coronary artery disease (CAD) and acute coronary syndromes (ACS) result from the complex interplay between genetic factors and environmental exposures over time. However, few studies have provided clarity around the interactions between different genes and environmental exposures and the resultant effects on cardiovascular (CV) phenotype. Even the model of gene-environment interaction is likely oversimplistic as there are likely to be multiple genes involved in: 1) the initiation of atherosclerosis; and 2) modification of the subclinical course, inter-playing with different environmental factors to influence the timing and the type of clinical presentation (Fig. 1). In this issue of the Journal, Tsimikas et al. (1) link for the first time the potential interactions between genetic factors influencing inflammation and exposure to modified lipids, and how this may influence the development of CAD and CV events.