Immune Mechanisms of Plaque Instability

Area of Science:

• Immunology
• Cardiovascular Medicine
• Pathophysiology

Background:

• Inflammation is central to atherosclerosis development and complications.
• Residual cardiovascular risk persists despite conventional therapies.
• Understanding immune mechanisms is crucial for novel therapeutic strategies.

Purpose of the Study:

• To review the role of immune cells in atherosclerosis.
• To discuss maladaptive immune phenomena in plaque destabilization.
• To explore systemic factors and novel contributors like gut dysbiosis.

Main Methods:

• Literature review of immune cell involvement in atherosclerosis.
• Discussion of trained immunity, T-cell conversion, and clonal hematopoiesis.
• Analysis of systemic crises, COVID-19, and gut microbiome influences.

Main Results:

• Key immune cells drive plaque initiation and progression.
• Maladaptive immune responses like trained immunity and T-cell conversion destabilize plaques.
• Systemic factors (stress, infection, COVID-19) and gut dysbiosis increase cardiovascular risk.

Conclusions:

• Targeting inflammatory pathways offers potential for residual cardiovascular risk management.
• Novel immune-driven mechanisms contribute significantly to plaque vulnerability.
• Further research into immune system roles is vital for advancing atherosclerosis treatment.