Ross R
Department of Pathology, University of Washington, Seattle.
Adv Nephrol Necker Hosp. 1990;19:79-86.
The response-to-injury hypothesis of atherosclerosis takes into account interactions among all of the cells found in the lesions of human atherosclerosis, the cytokines and growth factors that can be formed by each of these cells (which are in fact formed in vitro and which have been demonstrated in vivo). It should therefore be possible to develop new diagnostic tools that will help us to make early diagnoses for patients who are at risk and determine the state of lesion formation in these patients. An intriguing question that remains is the role of the T lymphocytes in these lesions. The presence of these cells, and some early preliminary data, indicating that antigens unique to the lesions of atherosclerosis are present in the lesions, suggest that many of the lesions of atherosclerosis represent immune or autoimmune responses. The nature of the antigens, the response to these antigens, and the role of antigen-antibody complexes in the process of atherogenesis are important questions to be answered before we reach an understanding of this complex disease process that causes 50% of all deaths in the United States and Western Europe.
动脉粥样硬化的损伤反应假说考虑了人类动脉粥样硬化病变中发现的所有细胞之间的相互作用，以及这些细胞各自能够形成的细胞因子和生长因子（事实上这些因子在体外已形成，且在体内也得到了证实）。因此，应该有可能开发出新的诊断工具，帮助我们对有风险的患者进行早期诊断，并确定这些患者的病变形成状态。一个仍然有趣的问题是T淋巴细胞在这些病变中的作用。这些细胞的存在以及一些早期的初步数据表明，动脉粥样硬化病变特有的抗原存在于病变中，这表明许多动脉粥样硬化病变代表免疫或自身免疫反应。在我们理解这种导致美国和西欧50%的人死亡的复杂疾病过程之前，抗原的性质、对这些抗原的反应以及抗原 - 抗体复合物在动脉粥样硬化形成过程中的作用是有待回答的重要问题。
