Pathogenesis of development of atheromatous plaque in carotid arteries
Magdalena Jóźwicka, Andrzej Głąbiński
It is scientifically confirmed that atherosclerosis simultaneously develops in the whole arterial system. The mechanism and character of atherosclerotic plaque formation is similar in different regions of the vascular system. The essence of atherosclerosis pathogenesis appears to be an excessive inflammatory and fibroproliferative response to various forms of arterial wall injury. The development of unstable atheromatous plaques is closely related to the inflammatory process involving the arterial wall. Immunological factors seem to play an important role in the development of atherosclerotic plaques and their destabilization. Unstable plaque is characterized by higher blood supply, thinner and more fragile fibrous layer and higher number of inflammatory cells. Lipid core of plaque is bigger and more rich in liquid cholesterol esters. Pathological and growing vessels are the main source of bleeding to plaque what leads to its rupture. Cytokines and growth factors have a strong impact on activation of atheromatous plaque. Finding of inflammatory markers of plaque destabilisation in blood serum may be an additional diagnostic tool useful for diagnosis and monitoring of stroke management. It should be stressed that a closer look at participation of the immune system in pathogenesis of artherosclerosis may contribute to a development of the new therapies of this pathology and its complications like ischaemic stroke.