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Quo Vadis, Atherogenesis? Part 1. Smooth Muscle Cell Secretion – How Foe Becomes Friend in the Fight Against the Atherosclerotic Plaque

Peter I. Ghenev, Luigi Aloe, Antoniya R. Kisheva, Manjinder Singh, Plamen Panayotov, Marco Fiore, George N. Chaldakov


Atherosclerosis is a chronic inflammatory disease in which exacerbation leads to myocardial infarction, stroke and/or lower limb ischemia. Phenotypic plasticity of artery smooth muscle cells (SMC) that can adapt to changes in the injured arterial microenvironment is a major determinant of atherosclerotic plaque vulnerability. Plaque instability has been associated with the ulceration or rupture of the fibrous cap composed primarily of SMC and collagen and elastin fibers, that covers the lipid core of the plaque. In this scenario, we, together with SMC, Dance round recent advances that have shed light on the relationship between inflammation, fibrosis and plaque vulnerability and stability. Specifically, we have addressed the question of how the secretory (fibrogenic) activity of SMC occurring within the plaque may become a plaque stabilizer (a friend). We describe a new paradigm shift in the cell biology of atherosclerosis that relates the inhibition of SMC matrix secretion and proliferation (the classical way for reducing plaque size) to the stimulation of these processes (the new way aimed at the plaque stabilization by increasing the thickness of its fibrous cap). Briefly, an increased secretion of matrix molecules, particularly collagen and elastin, by SMC could “shift” them from foe to friend in the fight against the vulnerable atherosclerotic plaque. Biomed Rev 2017; 28:134-138.

Keywords: atherosclerotic plaque, fibrous cap, smooth muscle cells, macrophages, phenotypic modulation, matrix proteins, inflammation, fibrosis, colchicine

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About The Authors

Peter I. Ghenev
Medical University, Varna

Department of General and Clinical Pathology

Luigi Aloe
National Research Council (CNR), Rome

Institute of Cell Biology and Neurobiology

Antoniya R. Kisheva
St Marina University Hospital, Varna

Clinic of Cardiology, Department of Internal Medicine

Manjinder Singh
Lovely Professional University, Phagwara, Punjab

School of Pharmaceutical Sciences

Plamen Panayotov
St Marina University Hospital, Varna

Department of Cardiac Surgery

Marco Fiore
National Research Council (CNR), Rome

Institute of Cell Biology and Neurobiology

George N. Chaldakov
Medical University, Varna

Department of Anatomy and Cell Biology

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