Human Atherosclerosis: New Participants?

  • Yu. A. Romanov
  • E. L. Soboleva
  • V. N. Smirnov
  • A. Bobik
Part of the Progress in Experimental Cardiology book series (PREC, volume 9)


Human atherosclerosis is multi-factorial disease involving several physiological and pathological mechanisms related to remodeling of vascular wall in response to various inflammatory, immune-autoimmune, hormonal, and other disturbances. In spite of such causal complexity, the list of cellular participants is limited to a few vascular and blood-borne cells. Here we demonstrate that human atherosclerosis, although chronic disease, causes same central response as does acute tissue injury, i.e. mobilization of bone marrow stem/progenitor cells into peripheral blood, gradual stem cell accumulation in the injury site followed by tissue remodeling. Driven by chemical signaling from inflammatory foci on vasculature lining, colony-forming units (CFUs) for hemopoietic lineages and pluripotent mesenchymal cells leave bone marrow and start to circulate in blood. A percentage of hemopoietic CFUs as well as of stromal CFUs become resident in aortic intima forming loci of ectopic hemopoiesis. On the other hand, stromal differentiation in vascular intima initiated by putative risk factors (including high LDL) results in fibrosis, formation of osteoid and chondroid matrices, calcification and appearance of osteoclasts and adipocytes. It is this sequence of events rather than migration and proliferation of smooth muscle cells form cellular basis of human atherosclerosis. From this point of view, human atherosclerosis is just natural cell therapy of vascular wall exerted via basic mechanism for tissue regeneration, i.e. mobilization of bone marrow stem/progenitor cells and their transport to injury location. Vascular stenosis is viewed as undesirable and unpredictable consequence of physiological cell therapy of vascular inflammation. The type of a particular plaque (fibrotic, ossified, adipocyte-rich, etc.) is determined by microenvironment where clonogenic bone marrow stem cell comes to.

Key words

atherosclerosis bone marrow endothelium colony-forming units mesenchymal stem cells extracellular matrix hypercholesterolemia 


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Copyright information

© Springer Science+Business Media New York 2003

Authors and Affiliations

  • Yu. A. Romanov
    • 1
  • E. L. Soboleva
    • 1
  • V. N. Smirnov
    • 1
  • A. Bobik
    • 2
  1. 1.Cardiology Research CenterMoscowRussia
  2. 2.Alfred Baker Medical UnitBaker Medical Research Institute & Alfred HospitalMelbourneAustralia

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