title: Inflammation and plaque vulnerability.
abstract: Atherosclerosis is a maladaptive, nonresolving chronic inflammatory disease that occurs at sites of blood flow disturbance. The disease usually remains silent until a breakdown of integrity at the arterial surface triggers the formation of a thrombus. By occluding the lumen, the thrombus or emboli detaching from it elicits ischaemic symptoms that may be life-threatening. Two types of surface damage can cause atherothrombosis: plaque rupture and endothelial erosion. Plaque rupture is thought to be caused by loss of mechanical stability, often due to reduced tensile strength of the collagen cap surrounding the plaque. Therefore, plaques with reduced collagen content are thought to be more vulnerable than those with a thick collagen cap. Endothelial erosion, on the other hand, may occur after injurious insults to the endothelium instigated by metabolic disturbance or immune insults. This review discusses the molecular mechanisms involved in plaque vulnerability and the development of atherothrombosis.
authors.affiliation: Department of Medicine and Center for Molecular Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
authors.forename: G K
authors.initials: GK
authors.lastname: Hansson
authors.affiliation: Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Libby
authors.affiliation: Department of Medicine, Department of Pathology and Cell Biology, and Department of Physiology, Columbia University Medical Center, New York, NY, USA.
authors.forename: I
authors.initials: I
authors.lastname: Tabas
mesh_terms: D000818:Animals; D057056:Cysteine Proteases / Q000378:metabolism; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007249:Inflammation / Q000276:immunology*; D020782:Matrix Metalloproteinases / Q000378:metabolism; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D012422:Rupture, Spontaneous / Q000150:complications / Q000378:metabolism / Q000503:physiopathology; D013923:Thromboembolism / Q000209:etiology
chemical_list: D057056:Cysteine Proteases; D020782:Matrix Metalloproteinases
keywords: atherosclerosis; atherothrombosis; en-dothelial erosion; inflammation; plaque rupture