Atherosclerosis is a lipid deposition disease that eventually leads to myocardial infarction, stroke, and ischemic gangrene. Furthermore, it is a chronic inflammatory condition characterized by smooth muscle cell proliferation, apoptosis, necrosis, fibrosis, and local inflammation. The atherosclerotic process is initiated when cholesterol-containing low-density lipoproteins accumulate in the intima and thereby activate the endothelium. Leukocyte adhesion molecules and chemokines contribute to monocyte recruitment, which in turn deteriorates atherosclerosis. Therefore, inflammation plays a key role in all stages of atherosclerosis progression. Anti-inflammatory cytokines ameliorate the disease, whereas pro-inflammatory cytokines accelerate atherosclerosis progression. Inflammatory markers are widely used to control the disease, and anti-inflammatory molecules are therapeutic targets for atherosclerotic diseases. Here, we review the potential role of the inflammatory system in accelerated atherosclerosis of cardiovascular diseases and several endocrine disorders and address drug discovery based on anti-inflammatory strategies in these diseases.
Inflammatory bowel disease (IBD) is defined as ulcerative colitis (UC) and Crohn's disease (CD). The number of patients with IBD is continuously increasing, with over 200,000 cases of UC and 70,000 cases of CD observed in a 2014 statistical analysis. The mechanisms underlying IBD inflammation remain unclear; however, previous studies have reported that a genetic predisposition to the disease exists. These disease-susceptibility genes, changes in the gut microbiota, and an overreaction to dietary antigens are presumed to cause an uncontrolled immune response, leading to intestinal inflammation. Therefore, drugs for the treatment of IBD are classical anti-inflammatory agents, and presently, new immunological drugs, that have been developed from the perspective of treating IBD, are used in clinical practice. The Japanese Ministry of Health, Labour and Welfare (MHLW) have developed guidelines for the treatment of IBD in Japan. Appropriate treatment for IBD may vary depending on the activity, extent of inflammation, and presence of complications. In this article, we will discuss the basic concepts of UC and CD as well as up-to-date information on medical treatment strategies in Japan.