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Inflammation is now considered as a critical process that closely escorts lipid disturbances in the initiation and progression of atherosclerosis. Oxidative process, particularly oxidation of LDL, by creating neo-epitopes, is a key initiator of the inflammatory reaction as it triggers both innate and adaptive immunity. This further induces the production of pro-inflammatory cytokines and the dysregulation of endothelial and hemostatic functions leading to atherosclerotic plaque growth and rupture. The specific role of some cytokines and receptors in the dysregulation of the Th1/Th2 response is now emerging to better approach the complex mechanisms inducing disturbances of the immunoinflammatory process in atherosclerosis.

ADAM17 was initially characterized as the TNF Alpha Converting Enzyme (TACE) and, until now, has been the most studied member of the ADAM family. It is a type I transmembrane metalloproteinase involved in the shedding of the extracellular domain of several transmembrane proteins (at least 40) such as cytokines, growth factors, receptors or adhesion molecules. As a consequence, depending on the transmembrane molecule cleaved, one may expect possible opposite effects of ADAM17 activity on inflammation (e.g. TNF and its receptors). The role of ADAM17 in regulating inflammatory cellular processes is clearly demonstrated in cells deficient in active ADAM17 or expressing substrates mutated for the ADAM17 cleavage site. As ADAM17-deficient mice died at birth, mice overexpressing the mutated uncleavable form of some substrates and recently conditional knock-out of ADAM17 are used to approach in vivo the role of this metalloprotease in regulating inflammation. Arguments are provided that ADAM17 plays a role in atherosclerosis, in adipose tissue metabolism, insulin resistance and diabetes. The multitude of substrates cleaved by ADAM17 makes this enzyme an attractive candidate to study its role in inflammation-driven pathologies.