Lipoproteins and the pathogenesis of atherosclerosis.
Lipoproteins and the pathogenesis of atherosclerosis.
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DOI：
10.1161/01.cir.76.3.508
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发表时间：
1987-09
期刊：
影响因子：
37.8
通讯作者：
D. Steinberg
中科院分区：
文献类型：
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作者：
D. Steinberg
现在很清楚，在某些情况下，高胆固醇血症可能是过早动脉粥样硬化的必要和充分原因。这在家族性高胆固醇血症（低密度脂蛋白受体缺乏）患者中得到了最好的证实。虽然高胆固醇血症不是动脉粥样硬化的唯一原因，但大量证据表明，在许多情况下，它是一个决定性的原因。本文综述了目前关于高胆固醇血症加速动脉粥样硬化发生机制的假设。泡沫细胞的作用进行了详细的讨论，因为它是早期病变的特征，即所谓的脂肪条纹。曾经认为泡沫细胞只来源于平滑肌细胞，现在已知泡沫细胞大部分来源于进入动脉壁并改变其特性成为组织巨噬细胞的单核细胞。最近对巨噬细胞衍生泡沫细胞的生物学研究为巨噬细胞进入动脉壁并与各种天然和修饰脂蛋白相互作用的机制提供了新的见解。随着我们对泡沫细胞及其前体的生物学理解的加深，通过与控制血浆胆固醇水平的措施协同作用的新方式来干预和减缓动脉粥样硬化的进展可能成为可能。
It is now clear that hypercholesterolemia can, in some instances, be a necessary and sufficient cause of premature atherosclerosis. This has been best established in patients with familial hypercholesterolemia, a deficiency of the low-density lipoprotein receptor. Although hypercholesterolemia is not the only cause of atherosclerosis, a large body of evidence has identified it as a determining cause in many cases. This article reviews current hypotheses regarding the mechanisms by which hypercholesterolemia accelerates atherogenesis. The role of the foam cell is discussed in detail because it is a characteristic feature of the earliest lesion, the so-called fatty streak. Once thought to derive exclusively from smooth muscle cells, the foam cell is now known to originate in large part from monocytes that enter the artery wall and alter their properties to become tissue macrophages. Recent studies of the biology of the macrophage-derived foam cell are providing new insights into the mechanisms by which it enters the arterial wall and interacts with various classes of native and modified lipoproteins. As our understanding of the biology of the foam cell and its precursors grows, it may become possible to intervene and slow the progress of atherosclerosis by new modalities that might act synergistically with measures to control plasma cholesterol levels.