Peter Libby教授  美国哈佛大学Brigham and Women’s Hospital心血管医学主任，学术重点是炎症在血管疾病中的作用
　　International Circulation: Atherosclerosis has been characterized recently as an inflammatory disease. There has been a lot of research into the inflammatory pathways that might lead to atherosclerosis. Which of these pathways do you think are most important for the genesis of atherosclerosis?
　　《国际循环》：近年来动脉粥样硬化被视为一种炎症性疾病。有大量研究观察了可能导致动脉粥样硬化的炎症途径。您认为哪种途径在动脉粥样硬化的发病中最为重要？
　　Prof Libby: The inflammatory pathways are extremely redundant and it is very difficult to single out a particular target. Most responses to such a question rely on answers from mouse experiments and I think we need to have caution about the direct translation of experiments on mice to the human situation. I wrote an article in Nature about a year ago with respect to that.
　　Prof Libby：体内存在许多的炎症旁路，要筛检出一个特别的目标非常困难。回答这一问题的数据，主要来自于小鼠的动物实验，我认为将这些小鼠实验结果直接推论到人体应保持谨慎。1年前我曾在Nature就这一问题发表过一篇文章。
　　International Circulation: You made a presentation at ISA2012 on biomarkers for atherosclerosis. Could you give us a breakdown of why biomarkers are especially important in the clinic right now?
　　《国际循环》：在ISA2012大会期间您就动脉粥样硬化的生物标志物作了专题报告。能否请您简要概括一下，为何在当前的临床实践中生物标志物非常重要？
　　Prof Libby: The important question is what you want to use a biomarker for. There is no such thing as a catalogue where there is a hierarchy of biomarkers and I have a few favorites. It is an issue of what is the question you want to ask. What do you want the biomarker to do for you? I started my talk by defining what a biomarker is using the NIH working group definitions from 1998 and having done that and knowing what a biomarker is， our interest is in them being a biomarker of what? Some of the needs may be for diagnosis， for risk stratification， for targeting therapy， as a goal of therapy and for drug development evaluation and registration. Those are different things you might want a biomarker to do for you. Biomarkers are numerous and I tried to cast some order amongst the chaos by stressing that there were different categories of biomarkers. There are those of neurohumoral activation such as the natriuretic peptides like BNP. There are markers of myocardial injury such as troponin. There are biomarkers of risk which could include things like LDL and HDL and the carotid intima-media thickness as markers of heart attack or stroke. Then there are biomarkers of inflammation such as CRP.
　　Prof Libby：一个很重要的问题是，你为何要使用一种生物标志物？并不存在一个目录列举生物标志物的重要等级，我本人比较偏重一些标志物。这取决于你想要回答的问题，你想利用这种标志物为你解决什么问题？我在报告的开头介绍了1998年NIH工作组对生物标志物所作的定义，即生物标志物是什么？我们为何对生物标志物产生兴趣？可能是将其用于诊断、危险分层、靶向治疗、用作治疗靶标、以及研发药物的评估和注册等。这些都是我们利用生物标志物的不同目的。生物标志物种类繁多，我试图通过强调其不同的分类将其条理化。其中有神经激素激活类标志物，如利钠肽中的BNP；有心肌损伤标志物如肌钙蛋白；有风险标志物包括LDL、HDL和颈动脉内膜中层厚度，均可作为心脏病发作或卒中的标志物；另外还有炎症标志物，如CRP。