Erosion of the Atheroma: Wicked T Cells at the Culprit Site

• Published in: Current atherosclerosis reports 2024-12, Vol.27 (1), p.4, Article 4
• Main Authors: Lin, Shiying, Yu, Yinda, Söderström, Leif Å, Gisterå, Anton
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - immunology; Acute Coronary Syndrome - pathology; Angiology; Animals; Atherosclerosis - complications; Atherosclerosis - immunology; Atherosclerosis - pathology; Cardiology; Humans; Macrophages - immunology; Medicine; Medicine & Public Health; Plaque, Atherosclerotic - complications; Plaque, Atherosclerotic - immunology; Plaque, Atherosclerotic - pathology; Review; T-Lymphocytes - immunology; Topical Collection on Atherosclerotic Plaque
• ISSN: 1523-3804; 1534-6242; 1534-6242
• DOI: 10.1007/s11883-024-01247-x

Purpose of Review There is a growing recognition of plaque erosion as a cause of acute coronary syndrome. This review aims to examine the potential involvement of T cells in this process. Recent Findings Immune-vascular interactions have been identified in the development of plaque erosions. Up to one-third of eroded plaques show evidence of active immune infiltration, with the presence of T cells. We propose that microerosions may frequently occur in association with the infiltration of T cells and macrophages in early atherosclerotic lesions. Healing of erosions could trigger the deposition of excessive extracellular matrix. The pro-inflammatory and cytotoxic actions of T cells, along with reduced endothelial integrity and other mechanisms, may subsequently give rise to clinical symptoms. Summary To gain a better understanding of the role of T cells in plaque erosion, it is crucial to develop improved models for conducting controlled experiments and to study atherosclerosis in younger individuals.