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The dawn has come for new therapeutics to treat atherosclerosis: Targeting neuroimmune cardiovascular interfaces in artery brain circuits

Clin Transl Med. 2022 Sep;12(9):e1040. doi: 10.1002/ctm2.1040. PMID: 36052959; PMCID: PMC9437971.

Authors/Editors: Mohanta SK, Weber C. Yin C, Habenicht AJR.
Publication Date: 2022

Abstract

Atherosclerosis is the leading cause of mortality worldwide. However, regrettably, there are no treatment options that target the root causes of the disease, as its pathogenic mechanisms largely remain to be defined. Atherosclerosis has been viewed as a chronic inflammatory and unresolvable condition of all three arterial wall layers: Plaques develop in the inner intima layer of arteries leading to lumen narrowing and reduction of blood flow to downstream tissues, and when critical thresholds are breached, they cause heart attacks and strokes; smooth muscle cells in the media layer transdifferentiate into a synthetic and migratory phenotype and participate in artery remodelling by changing their transcriptome profile and secreting cytokines; and immune cells accumulate in the outer connective tissue coat of arteries, that is, the adventitia, and adopt roles in atherosclerosis‐specific immune responses. Since atherosclerotic plaques are not innervated, until recently, the hardwired connections between the peripheral nervous system (PNS), the central NS (CNS) and the arterial wall remained unknown

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