Review Pathophysiology of Atherosclerosis

Review Pathophysiology of Atherosclerosis

Abstract: Atherosclerosis is the main risk factor for cardiovascular disease, which is the leading cause of mortality worldwide. Atherosclerosis is initiated by endothelium activation and, followed by a cascade of events (accumulation of lipids, fibrous elements, and calcification), triggers the vessel narrowing and activation of inflammatory pathways. The resultant atheroma plaque, along with these processes, results in cardiovascular complications. This review focuses on the different stages of atherosclerosis development, ranging from endothelial dysfunction to plaque rupture. In addition, the post-transcriptional regulation and modulation of atheroma plaque by microRNAs and lncRNAs, the role of microbiota, and the importance of sex as a crucial risk factor in atherosclerosis are covered here in order to provide a global view of the disease.

One. Introduction

Atherosclerosis is a disease that is characterized by the accumulation of lipids, fibrous elements, and calcification within the large arteries. This process is initiated by endothelium activation, followed by a cascade of events, which implies the vessel narrowing and activation of inflammatory pathways leading to atheroma plaque formation. Altogether, these processes result in cardiovascular complications that remain as the leading cause of death worldwide.

In this study, we aimed to review the mechanism of development of atherosclerosis, including endothelial dysfunction, fatty streak formation, fibrous plaque formation, and plaque rupture. This review approaches the pathophysiology of atherosclerosis from a broad perspective, examining the pathological and biochemical processes of atherosclerotic plaque formation and growth. In addition, this review summarizes the current understanding of the involvement of microRNAs and lncRNAs in post-transcriptional regulation and modulation of atheroma plaque and atherogenesis. Non-traditional drivers of atherosclerosis-such as disturbed sleep, physical inactivity, the microbiome, the role of microbiota, and the importance of sex as a crucial risk factor in atherosclerosis are covered here in order to provide a global view of the disease.