Dysregulated cellular metabolism drives atherosclerotic plaque progression: a multi-cellular perspective

Atherosclerosis (AS) is a chronic inflammatory disease that can lead to severe cardiovascular diseases, primarily characterized by the formation of plaques within arterial walls, resulting in vascular stenosis and hardening. Numerous studies have revealed the complex connection between dysregulated cellular metabolism, specifically metabolic reprogramming, and AS. However, a comprehensive understanding of metabolic reprogramming in AS and its potential as a therapeutic target still requires further exploration. This article provides a comprehensive review of the role of dysregulated cellular metabolism in AS, with a particular focus on the phenomenon of metabolic reprogramming in diseased cells. It discusses in detail the adjustments in lipid and glucose metabolism of macrophages, the metabolic responses of endothelial cells under blood flow shear stress, oxidative stress, and inflammatory stimulation, as well as the metabolic changes of smooth muscle cells during phenotypic transformation. Furthermore, it analyzes how these dysregulated cellular metabolism affect the development of AS. Additionally, the article outlines the mechanisms by which chemically synthesized drugs and Chinese patent medicines treat AS by regulating metabolic pathways, offering a new perspective for disease research and clinical treatment.