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What's atherosclerosis?
This is an intimal based lesion on the blood vessel wall comprised of an atheromatous lipid core and a fibromuscular cap.
What's the pathogenesis of atherosclerosis?
Vascular injury due to hypertension, hyperglycemia, smoking cigarette or diabetes leads to an endothelial dysfunction. This increases the permeability of the vessel and vasodilation. LDL cholesterol and cholesterol crystals migrate to the intima of the blood vessel, where LDL is oxidized by the oxygen free radicals to form oxidized LDL. The inflammatory cells ie macrophages and T cells are then recruited by the chemokines and cytokines produced by the injured endothelial cells. Macrophages in the intima ingest the oxidized LDL forming the foam cells. The LDL cholesterol then activates the macrophages to produce mediators like TNF, IL1 which recruit smooth muscle cells from the circulation and turcica media. The smooth muscle cell then proliferate and produce ECM proteins like collagen, forming a fibrous cap around the core. And that's the atheroma.
What's an atheroma?
This is a lesion on the blood vessel intimal layer composed of a fibrous cap around a lipid core.
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