Inserm LVTS U1148. CHU Bichat, 46 Rue Henri Huchard, 75018, Paris, France.
Atherosclerosis. 2021 Feb;318:60-69. doi: 10.1016/j.atherosclerosis.2020.11.002. Epub 2020 Nov 6.
Mechanical stress is a well-recognized driver of plaque rupture. Likewise, investigating the role of mechanical forces in plaque erosion has recently begun to provide some important insights, yet the knowledge is by far less advanced. The most significant example is that of shear stress, which has early been proposed as a possible driver for focal endothelial death and denudation. Recent findings using optical coherence tomography, computational sciences and mechanical models show that plaque erosion occurs most likely around atheromatous plaque throats with specific stress pattern. In parallel, we have recently shown that neutrophil-dependent inflammation promotes plaque erosion, possibly through a noxious action on ECs. Most importantly, spontaneous thrombosis - associated or not with EC denudation - can be impacted by hemodynamics, and it is now established that neutrophils promote thrombosis and platelet activation, highlighting a potential relationship between, mechanical stress, inflammation, and EC loss in the setting of coronary plaque erosion. Here, we review our current knowledge regarding the implication of both mechanical stress and neutrophils, and we discuss their implication in the promotion of plaque erosion via EC loss and thrombosis.
机械应力是斑块破裂的公认驱动因素。同样,最近开始研究机械力在斑块侵蚀中的作用,这提供了一些重要的见解,但目前的知识还远远不够先进。最显著的例子是切应力,它很早就被提出可能是导致局灶性内皮细胞死亡和剥脱的驱动因素。最近使用光学相干断层扫描、计算科学和机械模型的发现表明,斑块侵蚀最可能发生在具有特定应力模式的动脉粥样硬化斑块颈部周围。与此同时,我们最近表明,中性粒细胞依赖性炎症促进斑块侵蚀,可能是通过对 ECs 的有害作用。最重要的是,与 EC 剥脱相关或不相关的自发性血栓形成可受到血液动力学的影响,现在已经确定中性粒细胞促进血栓形成和血小板激活,这突出了在冠状动脉斑块侵蚀的情况下,机械应力、炎症和 EC 损失之间的潜在关系。在这里,我们回顾了我们目前关于机械应力和中性粒细胞的相关知识,并讨论了它们通过 EC 损失和血栓形成促进斑块侵蚀的作用。
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