[Atherosclerosis]

Atherosclerotic lesions can be characterized as accumulation of cholesterol esters and pathologic reactions by various cell groups. The pathogenesis of atherosclerosis has been discussed primarily on the basis of these two phenomena. A well-known concept to explain the etiology of atherosclerosis is the theory of response to injury. According to this theory, physiologically active substances such as platelet-derived growth factor (PDGF) and macrophage colony-stimulating factor (M-CSF) are released in response to injury of the vascular wall, and these substances induce pathologic reactions by the cells constituting the vascular wall. In the presence of excessive amounts of low-density lipoprotein (LDL), denatured LDL modified by oxidation or other reactions on the vascular wall is taken up by macrophages via scavenger receptors, resulting in the formation of foam cells and accumulation of cholesterol esters. Vitamins including Vitamin C and Vitamin E may play an important role in form cell formation by preventing the oxidation.