title: [The role of the vascular-associated lymphoid tissue (VALT) network and neovascularization in atherosclerotic carotid plaque].
abstract: As you know, atherosclerosis is a serious public problem and is the leading cause of morbidity and mortality not only in Western countries but also in Asia. Cervical carotid disease is typical atherosclerosis, which is responsible for ischemic stroke. Recently, it has been well established that the risk of an acute event mediated by rupture is predicated by plaque components rather than by the degree of luminal narrowing. Preoperative evaluation of plaque components by some modalities such as magnetic resonance imaging is very important for a decision of the treatment strategy. Generally, vulnerable plaques are characterized by a large lipid core, a thin fibrous cap, and substantial infiltration with inflammatory cells. Recently, evidence is accumulating for a role of the immune system and neovascularization in the progression of atherosclerosis. Neovascularization may act as a conduit for the entry of immune and inflammatory cells. Dendritic cells, macrophages, and T-lymphocytes play a main role in the immune-inflammatory system of atherosclerotic lesions, in which they form the vascular-associated lymphoid tissue (VALT) network together. The immune-inflammatory system in the VALT network plays a role in determining the dynamic balance between collagen degradation and collagen synthesis. On the other hand, some of these consecutive mechanisms related with plaque vulnerability have not yet been clarified. To clarify them, we should keep on researching the formation process of atherosclerotic carotid plaque from the pathohistological viewpoint.
authors.affiliation: Department of Neurosurgery, National Hospital Organization Nagasaki Medical Center, Omura City, Nagasaki, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawahara
authors.forename: Keisuke
authors.initials: K
authors.lastname: Tsutsumi
authors.forename: Izumi
authors.initials: I
authors.lastname: Nagata
mesh_terms: D050197:Atherosclerosis / Q000473:pathology*; D003952:Diagnostic Imaging / Q000379:methods; D004730:Endothelium, Vascular / Q000473:pathology*; D006801:Humans; D008221:Lymphoid Tissue / Q000473:pathology*; D009389:Neovascularization, Pathologic; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D015398:Signal Transduction / Q000502:physiology*