Molecular and Genetic Cardiovascular Pathophysiology Group, Epidemiology, Atherothrombosis and Imaging Department, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Melchor Fernandez Almagro 3, 28029 Madrid, Spain.
Immunobiology. 2011 Nov;216(11):1172-6. doi: 10.1016/j.imbio.2011.05.010. Epub 2011 May 24.
Atherosclerosis and associated cardiovascular disease are the leading causes of mortality in developed countries and the World Health Organization has estimated that by 2020 these disorders will be the main sanitary and socio-economic problem world-wide due in part to the progressive aging of our societies. Atherosclerosis is a complex chronic inflammatory process triggered and perpetuated by cardiovascular risk factors which cause endothelial dysfunction and leukocyte infiltration within the subendothelial space in the artery wall. In this review, we summarize the mechanisms that govern the recruitment of circulating monocytes into the incipient atherosclerotic lesion and their differentiation into macrophages. Moreover, we discuss current knowledge on macrophage polarization, a phenomenon of increasing interest given recent work suggesting that different stages in the progression of atherosclerosis are associated with the presence of distinct macrophage subtypes. Understanding the molecular mechanisms that orchestrate macrophage polarization and the precise role of distinct macrophage subsets should provide a basis for novel treatment strategies to limit the progression of atherosclerosis.
动脉粥样硬化及相关心血管疾病是发达国家的主要致死病因，世界卫生组织估计，到 2020 年，这些疾病将成为全世界主要的公共卫生和社会经济问题，这部分归因于社会的逐渐老龄化。动脉粥样硬化是一种复杂的慢性炎症过程，由心血管危险因素引发并持续存在，这些危险因素导致动脉壁内皮功能障碍和白细胞在内皮下空间的浸润。在这篇综述中，我们总结了控制循环单核细胞募集到初期动脉粥样硬化病变并分化为巨噬细胞的机制。此外，我们还讨论了巨噬细胞极化的最新知识，鉴于最近的研究表明，动脉粥样硬化进展的不同阶段与不同类型的巨噬细胞亚型的存在有关，这一现象引起了越来越多的关注。了解协调巨噬细胞极化的分子机制以及不同巨噬细胞亚群的确切作用，应为限制动脉粥样硬化进展的新治疗策略提供基础。
