Inflammation in atherosclerosis: Lessons and therapeutic implications

Area of Science:

• Cardiovascular Science
• Immunology
• Molecular Medicine

Background:

• Atherosclerosis is a chronic inflammatory disease.
• Inflammatory pathways are implicated in all disease stages, from initiation to complication.
• Cardiovascular risk factors trigger inflammatory responses in vascular cells and leukocytes.

Purpose of the Study:

• To review the mechanistic understanding of atherosclerosis etiology and progression.
• To discuss the role of cardiovascular risk factors in perturbing hematopoiesis.
• To delineate emerging therapeutic strategies for mitigating inflammation in atherosclerosis.

Main Methods:

• Review of mechanistic understanding of atherosclerosis.
• Discussion of how cardiovascular risk factors affect hematopoiesis.
• Analysis of myeloid cell behavior in atherosclerotic lesions.
• Examination of emerging therapeutic strategies.

Main Results:

• Cardiovascular risk factors converge at the bone marrow, influencing hematopoiesis towards a pro-inflammatory state.
• Circulating myeloid cells infiltrate, propagate, and persist within atherosclerotic lesions.
• Intimal macrophages are central regulators of the inflammatory environment within lesions.
• Emerging therapies aim to mitigate inflammation, complementing existing cardiovascular disease management.

Conclusions:

• Inflammation is a central driver of atherosclerosis throughout its lifecycle.
• Targeting inflammatory pathways, particularly those involving myeloid cells and bone marrow-derived hematopoiesis, offers therapeutic potential.
• Integrated strategies combining mechanistic insights and novel therapies are crucial for reducing the global burden of cardiovascular disease.