REVIEW   

Italian Journal of Vascular and Endovascular Surgery 2019 March;26(1):39-47

DOI: 10.23736/S1824-4777.18.01385-2

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Inflammation and immune response in carotid artery stenosis

Flavia DEL PORTO ¹, Noemi CIFANI ², Maria PROIETTA ³, Tommaso DEZI ⁴, Chiara PANZERA ⁴, Roberta FICARELLI ⁴, Maurizio TAURINO ⁴ ✉

¹ Unit of Internal Medicine, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, Rome, Italy; ² Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, Rome, Italy; ³ Unit of Atherosclerosis and Dyslipidemia, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, Rome, Italy; ⁴ Unit of Vascular Surgery, Department of Clinical and Molecular Medicine, Faculty of Medicine and Psychology, Sant’Andrea Hospital, Sapienza University, Rome, Italy

Atherosclerosis (ATS) is a multifactorial inflammatory disease representing the major cause of cardiovascular disease (ASCVD). Among ASCVD, carotid artery stenosis (CS) represent a serious health problem worldwide causing ≈10% of strokes. Immune response underlying ATS is complex and is characterized by the activation of both innate and adaptive immune responses. In this review article has been revised the contribution of the main cell populations and mediators involved in ATS. Monocytes play a central role in atherogenesis by their ability to differentiate into macrophages, thus leading to lipid accumulation and foam cells formation. T lymphocytes are present into the atherosclerotic plaque, where, in response to the local milieu of cytokines, differentiate into different subpopulations. The role of B cells in ATS is still under evaluation, due also to B cell heterogeneity. Mast cells, by release of their contents, may actively contribute to atherosclerotic plaque progression and destabilization. Matrix metalloproteinases and cytokines are also involved in atherosclerotic process. Mechanisms underlying CS are complex and are influenced by inflammatory immune response occurring during ATS. Thus, beside information coming from neuroimaging and laboratory data, the knowledge of immunologic mechanisms could contribute to improve treatment decisions for these patients.

KEY WORDS: Atherosclerosis - Carotid stenosis - Immune system