The pathogenesis of atherosclerosis: a perspective for the 1990s

  title={The pathogenesis of atherosclerosis: a perspective for the 1990s},
  author={R. Ross},
  • R. Ross
  • Published 29 April 1993
  • Medicine, Biology
  • Nature
Atherosclerosis, the principal cause of heart attack, stroke and gangrene of the extremities, is responsible for 50% of all mortality in the USA, Europe and Japan. The lesions result from an excessive, inflammatory-fibroproliferative response to various forms of insult to the endothelium and smooth muscle of the artery wall. A large number of growth factors, cytokines and vasoregulatory molecules participate in this process. Our ability to control the expression of genes encoding these… 

Pathophysiology of Intimal Hyperplasia

Accumulation of VSMC and monocytes, as well as deposition of matrix and lipids, indeed represent the main features of neointima formation during atherogenesis.

The pathogenesis of atherosclerosis.

This article attempts to summarize present knowledge on the events that take place within the arterial wall during atherogenesis, with particular emphasis on the cell types involved and the interactions between them.

Development of atherosclerosis and plaque biology.

Cell biology of atherosclerosis.

  • R. Ross
  • Medicine, Biology
    Annual review of physiology
  • 1995
The process of atherosclerosis is a life-threatening disease that affects critical organs including the heart and brain. It results from the influence of noxious agents associated with

The endothelium and cardiovascular disease--a complex relation.

  • T. Lüscher
  • Medicine, Biology
    The New England journal of medicine
  • 1994
Cardiovascular disease accounts for considerable mortality and morbidity in Western countries and vascular abnormalities have an important role in the pathogenesis of angina pectoris, myocardial infarction, stroke, and vascular forms of renal failure.

Rationale for Combined Therapy with Calcium Antagonists and Ace Inhibitors

The atherosclerotic lesion formation is a multifactorial process that involves several mechanisms: endothelial damage; lipid accumulation in the intimai tissue of the arterial vessel; smooth muscle cell proliferation and migration from the medial layer to the intimal layer of the artery.

Atherosclerosis: Pathologic Anatomy and Pathogenesis

Atherosclerosis develops as an inflammatory response of the vessel wall to chronic, multifactorial endothelial injury and involves endothelial dysfunction, leukocyte-endothelial cell interactions, intracellular and extracellular accumulation of cholesterol derived from oxidized LDL and smooth musele cell proliferation.

Role of interleukins in atherogenesis

The role interleukins that are released from both immune and non-immune cells of vascular wall may play on the process of atherogenesis are reviewed and it is speculated that these may serve as potential targets for therapeutic intervention.

The role of the endothelium in premature atherosclerosis: Molecular mechanisms.

The inflammation has a key role in the pathophysiological process of the disease and the infiltration of the intima from monocytes, macrophages and T-lymphocytes combined with endothelial dysfunction and accumulated oxidized low-density lipoprotein (LDL) are the main findings of atherogenesis.



The pathogenesis of atherosclerosis--an update.

  • R. Ross
  • Medicine
    The New England journal of medicine
  • 1986
A response-to-injury hypothesis of atherogenesis proposes that "injury" to the endothelium is the initiating event in atherosclerosis, and intimal smooth-muscle proliferation as the key event in the development of the advanced lesions of Atherosclerosis.

The Pathogenesis of Atherosclerosis: Atherogenesis and Inflammation

That Atherosclerosis has similarities to inflammation will be apparent from the considerations which follow, as will be the implications of these concepts to future work on the pathogenesis of atherosclerosis and its prevention and treatment.

Hyperlipidemia and atherosclerosis.

The present studies indicate that the effects of chronic hyperlipidemia are complex in that the condition results not only in the deposition of lipids in the atheromatous lesions but that it may produce the primary endothelial injury that initiates the process of atherosclerosis as well.

Localization of PDGF-B protein in macrophages in all phases of atherogenesis.

Platelet-derived growth factor (PDGF) B-chain protein was found within macrophages in all stages of lesion development in both human and nonhuman primate atherosclerosis and may play a critical role in the disease by providing PDGF, a potent chemotactic and growth-stimulatory molecule, to the intimal smooth muscle cells.

Biological and biochemical properties of fibroblast growth factors. Implications for the pathogenesis of atherosclerosis.

It is advanced to the understanding that the ultimate atherosclerotic lesion is a complex and heterogeneous arrangement of rapidly proliferating and migrating cells that produce and support an active connective tissue matrix.

George Lyman Duff memorial lecture. Persistent problems in the pathogenesis of atherosclerosis.

It is believed that coronary atherosclerosis has its origins in childhood, at least by age 10 and possibly earlier, and direct evidence bearing on these relationships, however difficult to obtain, would be helpful in designing and promoting effective preventive regimens for children.

Developmental mechanisms underlying pathology of arteries.

The data discussed here suggest that modulation of expression or function of cell-cell adhesive molecules could be critical both to morphogenic changes and to mitogenesis by release of cells from cell- cell contact.

Atherosclerosis and Hypertension: Mechanisms and Interrelationships

  • V. Dzau
  • Biology, Medicine
    Journal of cardiovascular pharmacology
  • 1990
Emphasis is now being placed on pharmacological therapeutic modalities that decrease blood pressure and improve insulin sensitivity and lipid metabolism, which should prevent or attenuate the vessel wall responses.

The Fibrinolytic System of the Vessel Wall and Its Role in the Control of Thrombosis

It is emphasized that the fibrinolytic system of the vessel wall plays an integral part in controlling normal and pathological thrombi, and the presence of type 1 plasminogen activator inhibitor (PAI-1) in plaque may prevent these systems from being activated.

Studies of Hypercholesterolemia in the Nonhuman Primate: II. Fatty Streak Conversion to Fibrous Plaque

The results of these studies helped to understand the complicated interrelationships between the various cells in atherogenesis, provided further support for the “Response to Injury Hypothesis of Atherosclerosis” and helped to explain how hypercholesterolemia may be involved in the different stages of Atherogenesis in nonhuman primates and possibly in humans.