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Updated: Sep 18, 2025
Quantitative Analysis of Cellular Composition in Advanced Atherosclerotic Lesions of Smooth Muscle Cell Lineage-Tracing Mice
Published on: February 20, 2019
Smooth muscle cells in atherosclerosis: essential but overlooked translational perspectives
Pascal Azar1, Kai-Uwe Jarr2,3, Delphine Gomez4,5
1Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Rue Michel-Servet 1, 1211 Geneva, Switzerland.
Insights
Smooth muscle cells are key in atherosclerosis development. Targeting these cells offers a promising new strategy for treating cardiovascular diseases and improving patient outcomes.
Area of Science:
- Cardiovascular Research
- Cell Biology
- Pathogenesis of Atherosclerosis
Background:
- Smooth muscle cells (SMCs) are the most abundant cells in atherosclerotic plaques, yet their role is often overlooked compared to inflammatory or endothelial cells.
- SMCs significantly contribute to plaque formation, progression, and cardiovascular disease outcomes.
- Understanding SMC behavior is critical for developing effective atherosclerosis treatments.
Purpose of the Study:
- To review the multifaceted roles of SMCs in atherosclerosis pathogenesis.
- To explore SMCs as potential therapeutic targets for cardiovascular diseases.
- To provide a comprehensive overview of current research on SMCs in human pathology.
Main Methods:
- Comprehensive literature review focusing on SMCs in atherosclerosis.
- Analysis of SMC phenotypic diversity, function, and localization within plaques.
- Evaluation of SMC clonal expansion and its impact on plaque progression.
Main Results:
- SMCs exhibit significant phenotypic diversity influencing plaque stability and instability.
- Clonal expansion of SMCs is a key driver of atherosclerotic plaque growth.
- Emerging diagnostic tools can reflect SMC physiology, aiding in disease assessment.
Conclusions:
- Modulating SMC behavior presents a promising therapeutic avenue for cardiovascular diseases.
- Clinical translation of SMC-targeted therapies requires addressing specific challenges and opportunities.
- Further research into SMCs is essential for advancing atherosclerosis treatment strategies.
Abstract:
Smooth muscle cells have been identified as the most abundant cell type present in the atherosclerotic plaque, the culprit underlying most cardiovascular diseases and their fatal outcomes. Despite their crucial role in plaque formation and progression, smooth muscle cells do not receive as much attention as inflammatory or endothelial cells. The purpose of this review is to examine the roles of smooth muscle cells in the pathogenesis of atherosclerosis and their potential as therapeutic targets. A comprehensive overview of current insights into smooth muscle cell phenotypic diversity, function, and spatial localization within stable and unstable plaques, focusing on their relevance to human pathology is discussed. The review also addresses the contribution of clonal expansion of smooth muscle cells in plaque progression, evaluates emerging diagnostic tools which may reflect smooth muscle cell physiology, and highlights strategies to modulate smooth muscle cell behaviour for improved cardiovascular outcomes. Special attention is given to the clinical translation of these therapies, considering the challenges and opportunities in leveraging smooth muscle cells as therapeutic targets.
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