101
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Sheedy FJ, Grebe A, Rayner KJ, Kalantari P, Ramkhelawon B, Carpenter SB, Becker CE, Ediriweera HN, Mullick AE, Golenbock DT, Stuart LM, Latz E, Fitzgerald KA, Moore KJ. CD36 coordinates NLRP3 inflammasome activation by facilitating intracellular nucleation of soluble ligands into particulate ligands in sterile inflammation. Nat Immunol 2013; 14:812-20. [PMID: 23812099 PMCID: PMC3720827 DOI: 10.1038/ni.2639] [Citation(s) in RCA: 676] [Impact Index Per Article: 61.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Accepted: 05/09/2013] [Indexed: 12/23/2022]
Abstract
Particulate ligands including cholesterol crystals and amyloid fibrils induce NLRP3-dependent production of interleukin-1β (IL-1β) in atherosclerosis, Alzheimer's disease and diabetes. Soluble endogenous ligands including oxidized-LDL, amyloid-β and amylin peptides accumulate in these diseases. Here we identify a CD36-mediated endocytic pathway that coordinates the intracellular conversion of these soluble ligands to crystals or fibrils, resulting in lysosomal disruption and NLRP3-inflammasome activation. Consequently, macrophages lacking CD36 failed to elicit IL-1β production in response to these ligands and targeting CD36 in atherosclerotic mice reduced serum IL-1β and plaque cholesterol crystal accumulation. Collectively, these findings highlight the importance of CD36 in the accrual and nucleation of NLRP3 ligands from within the macrophage and position CD36 as a central regulator of inflammasome activation in sterile inflammation.
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Affiliation(s)
- Frederick J Sheedy
- Department of Medicine, Marc and Ruti Bell Program for Vascular Biology and Disease, The Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, New York, USA
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102
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Rosenfeld ME. Inflammation and atherosclerosis: direct versus indirect mechanisms. Curr Opin Pharmacol 2013; 13:154-60. [PMID: 23357128 DOI: 10.1016/j.coph.2013.01.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 01/05/2013] [Accepted: 01/07/2013] [Indexed: 12/15/2022]
Abstract
It is now widely accepted that the development of atherosclerotic lesions involves a chronic inflammatory response that includes both innate and adaptive immune mechanisms. However, it is still unclear precisely what induces the inflammatory response. Furthermore, inflammation within the blood vessel can be divided into direct mechanisms where the primary inflammatory events occur within the intima of the blood vessel and contribute to both the initiation and progression of the plaques and indirect mechanisms where inflammation at nonvascular sites can contribute to the progression of the lesions. The direct mechanisms include lipid deposition and modification, influx of lipoprotein associated factors and microparticles derived from many different cell types, and possibly bacterial and viral infection of vascular cells. Indirect mechanisms derive from inflammation related to autoimmune diseases, smoking, respiratory infection, and pollution exposure, and possibly periodontal disease and gastric infection. The mechanisms include secretion of cytokines and other inflammatory factors into the circulation with subsequent uptake into the plaques, egress and recruitment of activated inflammatory cells, formation of dysfunctional HDL and crossreactive autoantibodies.
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103
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Statines et plaque. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2012. [DOI: 10.1016/s1878-6480(12)70844-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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104
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Wong BW, Meredith A, Lin D, McManus BM. The biological role of inflammation in atherosclerosis. Can J Cardiol 2012; 28:631-41. [PMID: 22985787 DOI: 10.1016/j.cjca.2012.06.023] [Citation(s) in RCA: 126] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 06/26/2012] [Accepted: 06/27/2012] [Indexed: 01/11/2023] Open
Abstract
The concept of the involvement of inflammation in the pathogenesis of atherosclerosis has existed since the 1800s, stemming from sentinel pathologic observations made by Rudolf Virchow, Karl Rokitansky, and others. Our understanding of the complex role played by immune and inflammatory mediators in the initiation and progression of atherosclerosis has evolved considerably in the intervening years, and today, a dramatically evolved understanding of these processes has led to advances in both diagnostic and prognostic approaches, as well as novel treatment modalities targeting inflammatory and immune mediators. Therapeutic interventions working through multiple mechanisms involved in atheroma pathogenesis, such as statins, which both lower lipids and alter the inflammatory milieu in the vessel wall, hold promise for the future. In this brief review, we explore the biological role of inflammation in atherosclerosis, with a focus on cellular involvement in both acute and chronic inflammation, and outline novel biomarkers of inflammation and atherosclerosis with a particular focus on the potential application of these novel approaches in improving strategies for disease diagnosis and management.
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Affiliation(s)
- Brian W Wong
- UBC James Hogg Research Centre, Institute for Heart and Lung Health, St Paul's Hospital, University of British Columbia, Vancouver, BC, Canada
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105
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Ma Y, Wang W, Zhang J, Lu Y, Wu W, Yan H, Wang Y. Hyperlipidemia and atherosclerotic lesion development in Ldlr-deficient mice on a long-term high-fat diet. PLoS One 2012; 7:e35835. [PMID: 22558236 PMCID: PMC3338468 DOI: 10.1371/journal.pone.0035835] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2011] [Accepted: 03/23/2012] [Indexed: 11/19/2022] Open
Abstract
Background Mice deficient in the LDL receptor (Ldlr−/− mice) have been widely used as a model to mimic human atherosclerosis. However, the time-course of atherosclerotic lesion development and distribution of lesions at specific time-points are yet to be established. The current study sought to determine the progression and distribution of lesions in Ldlr−/− mice. Methodology/Principal Findings Ldlr-deficient mice fed regular chow or a high-fat (HF) diet for 0.5 to 12 months were analyzed for atherosclerotic lesions with en face and cross-sectional imaging. Mice displayed significant individual differences in lesion development when fed a chow diet, whereas those on a HF diet developed lesions in a time-dependent and site-selective manner. Specifically, mice subjected to the HF diet showed slight atherosclerotic lesions distributed exclusively in the aortic roots or innominate artery before 3 months. Lesions extended to the thoracic aorta at 6 months and abdominal aorta at 9 months. Cross-sectional analysis revealed the presence of advanced lesions in the aortic sinus after 3 months in the group on the HF diet and in the innominate artery at 6 to 9 months. The HF diet additionally resulted in increased total cholesterol, LDL, glucose, and HBA1c levels, along with the complication of obesity. Conclusions/Significance Ldlr-deficient mice on the HF diet tend to develop site-selective and size-specific atherosclerotic lesions over time. The current study should provide information on diet induction or drug intervention times and facilitate estimation of the appropriate locations of atherosclerotic lesions in Ldlr−/− mice.
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Affiliation(s)
- Yanling Ma
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Wenyi Wang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Jie Zhang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Youli Lu
- Central Laboratory, Shanghai Xuhui Central Hospital, Shanghai, China
| | - Wenyu Wu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Hong Yan
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Yiping Wang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
- * E-mail:
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106
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Suhalim J, Chung CY, Lilledahl M, Lim R, Levi M, Tromberg B, Potma E. Characterization of cholesterol crystals in atherosclerotic plaques using stimulated Raman scattering and second-harmonic generation microscopy. Biophys J 2012; 102:1988-95. [PMID: 22768956 PMCID: PMC3328706 DOI: 10.1016/j.bpj.2012.03.016] [Citation(s) in RCA: 94] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 03/05/2012] [Accepted: 03/12/2012] [Indexed: 02/04/2023] Open
Abstract
Cholesterol crystals (ChCs) have been identified as a major factor of plaque vulnerability and as a potential biomarker for atherosclerosis. Yet, due to the technical challenge of selectively detecting cholesterol in its native tissue environment, the physiochemical role of ChCs in atherosclerotic progression remains largely unknown. In this work, we demonstrate the utility of hyperspectral stimulated Raman scattering (SRS) microscopy combined with second-harmonic generation (SHG) microscopy to selectively detect ChC. We show that despite the polarization sensitivity of the ChC Raman spectrum, cholesterol monohydrate crystals can be reliably discriminated from aliphatic lipids, from structural proteins of the tissue matrix and from other condensed structures, including cholesteryl esters. We also show that ChCs exhibit a nonvanishing SHG signal, corroborating the noncentrosymmetry of the crystal lattice composed of chiral cholesterol molecules. However, combined hyperspectral SRS and SHG imaging reveals that not all SHG-active structures with solidlike morphologies can be assigned to ChCs. This study exemplifies the merit of combining SRS and SHG microscopy for an enhanced label-free chemical analysis of crystallized structures in diseased tissue.
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Affiliation(s)
- Jeffrey L. Suhalim
- Beckman Laser Institute, University of California, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, California
| | - Chao-Yu Chung
- Department of Chemistry, University of California, Irvine, California
| | - Magnus B. Lilledahl
- Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ryan S. Lim
- Beckman Laser Institute, University of California, Irvine, California
| | - Moshe Levi
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado Denver, Aurora, Colorado
| | - Bruce J. Tromberg
- Beckman Laser Institute, University of California, Irvine, California
- Department of Biomedical Engineering, University of California, Irvine, California
| | - Eric O. Potma
- Beckman Laser Institute, University of California, Irvine, California
- Department of Chemistry, University of California, Irvine, California
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107
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The Role of NLR-related Protein 3 Inflammasome in Host Defense and Inflammatory Diseases. Int Neurourol J 2012; 16:2-12. [PMID: 22500248 PMCID: PMC3321399 DOI: 10.5213/inj.2012.16.1.2] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 03/20/2012] [Indexed: 12/22/2022] Open
Abstract
Among a number of innate receptors, the nucleotide-binding domain leucine-rich repeat containing (NLR) nucleotide oligomerization domain (NOD)-like receptor families are involved in the recognition of cytosolic pathogen- or danger-associated molecules. Activation of these specific sets of receptors leads to the assembly of a multiprotein complex, the inflammasome, leading to the activation of caspase-1 and maturation of the cytokines interleukin (IL)-1β, IL-18, and IL-33. Among NLRs, NLR-related protein 3 (NLRP3) is one of the best-characterized receptors that activates the inflammasome. There is no doubt that NLRP3 inflammasome activation is important for host defense and effective pathogen clearance against fungal, bacterial, and viral infection. In addition, mounting evidence indicates that the NLRP3 inflammasome plays a role in a variety of inflammatory diseases, including gout, atherosclerosis, and type II diabetes, as well as under conditions of cellular stress or injury. Here, we review recent advances in our understanding of the role of the NLRP3 inflammasome in host defense and various inflammatory diseases.
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108
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Calcified atherosclerotic plaque - where exactly is the calcium and what does it contain? Indian J Thorac Cardiovasc Surg 2012. [DOI: 10.1007/s12055-012-0133-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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109
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Mughal MM, Khan MK, DeMarco JK, Majid A, Shamoun F, Abela GS. Symptomatic and asymptomatic carotid artery plaque. Expert Rev Cardiovasc Ther 2012; 9:1315-30. [PMID: 21985544 DOI: 10.1586/erc.11.120] [Citation(s) in RCA: 102] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Carotid atherosclerotic plaques represent both stable and unstable atheromatous lesions. Atherosclerotic plaques that are prone to rupture owing to their intrinsic composition such as a large lipid core, thin fibrous cap and intraplaque hemorrhage are associated with subsequent thromboembolic ischemic events. At least 15-20% of all ischemic strokes are attributable to carotid artery atherosclerosis. Characterization of plaques may enhance the understanding of natural history and ultimately the treatment of atherosclerotic disease. MRI of carotid plaque and embolic signals during transcranial Doppler have identified features beyond luminal stenosis that are predictive of future transient ischemic attacks and stroke. The value of specific therapies to prevent stroke in symptomatic and asymptomatic patients with severe carotid artery stenosis are the subject of current research and analysis of recently published clinical trials that are discussed in this article.
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Affiliation(s)
- Majid M Mughal
- Department of Medicine, Division of Cardiology, Michigan State University, 138 Service Road, B208 Clinical Center, East Lansing, MI 48824, USA
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110
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Yakovlev VV, Petrov GI, Zhang HF, Noojin GD, Thomas PA, Denton ML, Rockwell BA, Thomas RJ. Chemically Specific Imaging Through Stimulated Raman Photoexcitation and Ultrasound Detection: Minireview. Aust J Chem 2012; 65:260-265. [PMID: 23807817 PMCID: PMC3691871 DOI: 10.1071/ch11407] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
A powerful combination of chemically specific Raman excitation and deep tissue ultrasound imaging holds the promise to attain spatially resolved distribution of chemical compounds inside the scattering medium. In this report, an attempt is made to evaluate the recent achievements and possible challenges with an eye on potential clinical applications.
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Affiliation(s)
- Vladislav V. Yakovlev
- Department of Physics, University of Wisconsin – Milwaukee, Milwaukee, WI 53211, USA
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Georgi I. Petrov
- Department of Physics, University of Wisconsin – Milwaukee, Milwaukee, WI 53211, USA
- Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA
| | - Hao F. Zhang
- Biomedical Engineering Department, Northwestern University, Evanston, IL 00555-9642, USA
| | - Gary D. Noojin
- Biomedical Sciences and Technologies Department, Tas.C, Inc., San Antonio, TX 78228, USA
| | - Patrick A. Thomas
- US Air Force Research Laboratory, 711 HPW/RHDO, Brooks City-Base, TX 78235, USA
| | - Michael L. Denton
- Biomedical Sciences and Technologies Department, Tas.C, Inc., San Antonio, TX 78228, USA
| | | | - Robert J. Thomas
- US Air Force Research Laboratory, 711 HPW/RHDO, Brooks City-Base, TX 78235, USA
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111
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Lim RS, Suhalim JL, Miyazaki-Anzai S, Miyazaki M, Levi M, Potma EO, Tromberg BJ. Identification of cholesterol crystals in plaques of atherosclerotic mice using hyperspectral CARS imaging. J Lipid Res 2011; 52:2177-2186. [PMID: 21949051 DOI: 10.1194/jlr.m018077] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The accumulation of lipids, including cholesterol, in the arterial wall plays a key role in the pathogenesis of atherosclerosis. Although several advances have been made in the detection and imaging of these lipid structures in plaque lesions, their morphology and composition have yet to be fully elucidated, particularly in different animal models of disease. To address this issue, we analyzed lipid morphology and composition in the atherosclerotic plaques of two animal models of disease, the low density lipoprotein receptor-deficient (LDLR(-/-)) mouse and the ApoE lipoprotein-deficient (ApoE(-/-)) mouse, utilizing hyperspectral coherent anti-Stokes Raman scattering (CARS) microscopy in combination with principal component analysis (PCA). Hyperspectral CARS imaging revealed lipid-rich macrophage cells and condensed needle-shaped and plate-shaped lipid crystal structures in both mice. Spectral analysis with PCA and comparison to spectra of pure cholesterol and cholesteryl ester derivatives further revealed these lipid structures to be pure cholesterol crystals, which were predominantly observed in the ApoE(-/-) mouse model. These results illustrate the ability of hyperspectral CARS imaging in combination with multivariate analysis to characterize atherosclerotic lipid morphology and composition with chemical specificity, and consequently, provide new insight into the formation of cholesterol crystal structures in atherosclerotic plaque lesions.
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Affiliation(s)
- Ryan S Lim
- Department of Physiology and Biophysics, University of California, Irvine, CA; Laser Microbeam and Medical Program (LAMMP), University of California, Irvine, CA
| | - Jeffrey L Suhalim
- Laser Microbeam and Medical Program (LAMMP), University of California, Irvine, CA; Beckman Laser Institute, Department of Biomedical Engineering, University of California, Irvine, CA; Center for Complex Biological Systems, University of California, Irvine, CA and
| | - Shinobu Miyazaki-Anzai
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado, Denver, CO
| | - Makoto Miyazaki
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado, Denver, CO
| | - Moshe Levi
- Division of Renal Diseases and Hypertension, Department of Medicine, University of Colorado, Denver, CO
| | - Eric O Potma
- Laser Microbeam and Medical Program (LAMMP), University of California, Irvine, CA; Center for Complex Biological Systems, University of California, Irvine, CA and; Department of Chemistry, University of California, Irvine, CA; and
| | - Bruce J Tromberg
- Laser Microbeam and Medical Program (LAMMP), University of California, Irvine, CA; Beckman Laser Institute, Department of Biomedical Engineering, University of California, Irvine, CA; Center for Complex Biological Systems, University of California, Irvine, CA and.
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112
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Patel R, Janoudi A, Vedre A, Aziz K, Tamhane U, Rubinstein J, Abela OG, Berger K, Abela GS. Plaque Rupture and Thrombosis Are Reduced by Lowering Cholesterol Levels and Crystallization With Ezetimibe and Are Correlated With Fluorodeoxyglucose Positron Emission Tomography. Arterioscler Thromb Vasc Biol 2011; 31:2007-14. [DOI: 10.1161/atvbaha.111.226167] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objective—
This study evaluated effects of lipid lowering with ezetimibe on plaque burden and associated cholesterol crystallization and inflammation in a rabbit model of plaque disruption and thrombosis.
Methods and Results—
Atherosclerotic rabbits (Group I, n=10 without; Group II, n=12 with ezetimibe, 1 mg/kg per day) were pharmacologically triggered for plaque disruption. Fluorodeoxyglucose positron emission tomography, RAM 11 macrophage staining, and serum inflammatory markers detected arterial inflammation. Serum and aortic wall cholesterol levels were measured, and thrombus area was planimetered. Cholesterol crystal density on aortic surface was scored (0 to +3) by scanning electron microscopy. Serum and aortic wall cholesterol, plaque area, and thrombosis area were significantly lower in Group II versus Group I (83.4±106.4 versus 608±386 mg/dL,
P
=0.002; 3.12±1.40 versus 9.39±5.60 mg/g,
P
=0.003; 10.84±1.6 versus 17.48±1.8 mm
2
,
P
<0.001; and 0.05±0.15 versus 0.72±0.58 mm
2
,
P
=0.01, respectively). There were significant correlations between crystal density and plaque area (
r
=0.75,
P
<0.003) and between crystal density and RAM 11 (
r
=0.82,
P
<0.001). Scanning electron microscopy demonstrated that there were fewer crystals in Group II versus Group I (+1.2±0.61 versus +2.4±0.63,
P
<0.001) and less inflammation detected by fluorodeoxyglucose positron emission tomography and RAM 11 (
P
<0.004 and
P
<0.04, respectively).
Conclusion—
Lowering cholesterol levels with ezetimibe reduced plaque burden, crystallization, and inflammation, preventing plaque disruption and thrombosis.
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Affiliation(s)
- Roshan Patel
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
| | - Abed Janoudi
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
| | - Ameeth Vedre
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
| | - Kusai Aziz
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
| | - Umesh Tamhane
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
| | - Jack Rubinstein
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
| | - Oliver G. Abela
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
| | - Kevin Berger
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
| | - George S. Abela
- From the Division of Cardiology, Department of Medicine (R.P., A.J., A.V., K.A., U.T., O.G.A., G.S.A.), Department of Radiology (K.B.), and Division of Pathology, Department of Physiology (G.S.A.), Michigan State University, East Lansing, MI; Division of Cardiology, University of Cincinnati, Cincinnati, OH (J.R.)
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113
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Buschini E, Piras A, Nuzzi R, Vercelli A. Age related macular degeneration and drusen: neuroinflammation in the retina. Prog Neurobiol 2011; 95:14-25. [PMID: 21740956 DOI: 10.1016/j.pneurobio.2011.05.011] [Citation(s) in RCA: 163] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Revised: 05/03/2011] [Accepted: 05/09/2011] [Indexed: 12/19/2022]
Abstract
Inflammation protects from dangerous stimuli, restoring normal tissue homeostasis. Inflammatory response in the nervous system ("neuroinflammation") has distinct features, which are shared in several diseases. The retina is an immune-privileged site, and the tight balance of immune reaction can be disrupted and lead to age-related macular disease (AMD) and to its peculiar sign, the druse. Excessive activation of inflammatory and immunological cascade with subsequent induction of damage, persistent activation of resident immune cells, accumulation of byproducts that exceeds the normal capacity of clearance giving origin to a chronic local inflammation, alterations in the activation of the complement system, infiltration of macrophages, T-lymphocytes and mast-cells from the bloodstream, participate in the mechanisms which originate the drusen. In addition, aging of the retina and AMD involve also para-inflammation, by which immune cells react to persistent stressful stimuli generating low-grade inflammation, aimed at restoring function and maintaining tissue homeostasis by varying the set point in relation to the new altered conditions. This mechanism is also seen in the normal aging retina, but, in the presence of noxious stimuli as in AMD, it can become chronic and have an adverse outcome. Finally, autophagy may provide new insights to understand AMD pathology, due to its contribution in the removal of defective proteins. Therefore, the AMD retina can represent a valuable model to study neuroinflammation, its mechanisms and therapy in a restricted and controllable environment. Targeting these pathways could represent a new way to treat and prevent both exudative and dry forms of AMD.
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Affiliation(s)
- Elisa Buschini
- NICO, Neuroscience Institute of the Cavalieri Ottolenghi Foundation, University of Torino, Regione Gonzole 10, Orbassano (TO), Italy.
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114
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Abela GS, Vedre A, Janoudi A, Huang R, Durga S, Tamhane U. Effect of statins on cholesterol crystallization and atherosclerotic plaque stabilization. Am J Cardiol 2011; 107:1710-7. [PMID: 21507364 DOI: 10.1016/j.amjcard.2011.02.336] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2010] [Revised: 02/11/2011] [Accepted: 02/11/2011] [Indexed: 10/18/2022]
Abstract
Pleiotropic effects of statins have not been fully elucidated. Recently we demonstrated that cholesterol expands when crystallizing and may trigger plaque rupture. The present study evaluated the potential direct effects of statins in altering cholesterol crystallization as a possible mechanism for plaque stabilization independent of cholesterol lowering. Cholesterol powder was dissolved in oil with and without pravastatin, simvastatin, or atorvastatin (10 to 90 mg) and then allowed to crystallize to measure peak volume expansion (ΔVE) in graduated cylinders. Effect of ΔVE on fibrous membrane damage was also evaluated. Human coronary, carotid, and peripheral arterial plaques (65 plaques from 55 patients) were incubated with statin or saline solution using matched plaque segments to evaluate direct effects of statins on preformed crystals. Also, the effect of in vivo use of oral statins on crystal structure was examined by scanning electron microscopy and crystal content in plaques scored from 0 to +3. For all statins, ΔVE decreased significantly in a dose-dependent fashion (0.76 ± 0.1 vs 0 ml at 60 mg, p <0.001). By scanning electron microscopy crystal structure with statins had loss of pointed tip geometries, averting fibrous membrane damage. Cholesterol crystal density was markedly decreased and appeared dissolved in human plaques incubated with statins (+2.1 ± 1.1 vs +1.3 ± 1.0, p = 0.0001). Also, plaques from patients taking oral statins compared to controls had significantly more dissolving crystals (p = 0.03). In conclusion, statins decreased ΔVE by altering cholesterol crystallization and blunting sharp-tipped crystal structure and dissolving cholesterol crystals in human arteries in vivo and in vitro, providing plaque stabilization.
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115
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Gadeela N, Rubinstein J, Tamhane U, Huang R, Pathak DR, Hosein HA, Rich M, Dhar G, Abela GS. The Impact of Circulating Cholesterol Crystals on Vasomotor Function. JACC Cardiovasc Interv 2011; 4:521-9. [DOI: 10.1016/j.jcin.2011.02.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 02/02/2011] [Accepted: 02/18/2011] [Indexed: 10/18/2022]
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