[Initial changes in the vascular metabolism and their relations to atherogenesis]

In a survey initial changes of the metabolism of the vascular wall under the influence of atherogenic noxae in the animal experiment are described. Already a short time after the effect of atherogenic noxae (so-called proliferative phase) the activities of respiratory mitochondrial enzymes in the cells of the smooth muscles of the tunica media of the aorta are considerably reduced in different species. It is a clue to the fact that a hypoxically induced defect in the arterial wall is to be taken into considerations as a pathogenetic factor for arteriosclerosis. Up to now there are no exact proofs for the fact that a transition to a high rate of glycolysis would be predisposing for the appearance of arteriosclerotic changes. The influence of a hypoxia on the vascular wall is not only restricted to the cellular energy metabolism, but stimulates also other cellfunctions. Under hypoxic conditions the synthesis of fatty acids in the arterial tissue is increased. Several authors are of the opinion that a continuous increased supply of lipids overchanges the processes of the cellular regulation which are responsible for the metabolisation of the lipids. The transition into the proliferative phase is characterized by increased insertion rates or transformation rates for different substances in the activated myointimal cells which focally or generally leads to a proliferation or migration into the intima. The proliferating cells distinguish themselves by high activities of different oxidative enzymes which is to be regarded as a reference to an increased readiness of connections rich in energy, according to the high synthetic capacity of these multifunctional mesenchymal cells.