Endothelial Dysfunction and Atherosclerosis
The concept of endothelial “injury,” or dysfunction, has been central to the “response to injury” hypothesis of atherosclerosis, which was formulated in 19731 and has been modified and retested for the past 16 years.2–4 This hypothesis proposes that many forms of functional alteration may occur in the endothelium, some of which may have morphologic manifestations, whereas others may induce no visible change. These changes may lead to a series of cellular interactions at focal sites within the artery wall. They involve white cells of the blood (T lymphocytes and monocyte/macrophages) and cells of the artery wall (endothelium and smooth muscle) in a series of complex interactions that lead to the development of fatty streaks, fibrofatty (or intermediate) lesions, and ultimately to fibrous plaques, which may become the advanced, complicated, ulcerated, or calcified occlusive lesions of atherosclerosis.
KeywordsSmooth Muscle Cell Nonhuman Primate Artery Wall Fatty Streak Short Arrow
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