Intraplaque Hemorrhage and Progression of Coronary Atheroma

Kolodgie, Frank D.; Gold, Herman K.; Burke, Allen; Fowler, David; Kruth, Howard S.; Weber, Deena K.; Farb, Andrew; Guerrero, Luis; Hayase, Motoya; Kutys, Robert; Narula, Jagat; Finn, Aloke V.; Virmani, Renu

doi:10.1056/nejmoa035655

Cited by 1,275 publications

(673 citation statements)

References 33 publications

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“…Cite this article as Cold Spring Harb Perspect Med 2012;2:a006486 atherosclerotic plaque development is a young and relatively unexplored area, evidence does suggest that new vessel formation in the coronary plaque vasa vasorum is an important contributor to disease progression and plaque complications (Jeziorska and Woolley 1999;Kolodgie et al 2003;Virmani et al 2005;Jain et al 2007). Indeed, hypoxia within plaques drives angiogenesis and an abnormal vasculature.…”

Section: Vascular Normalizationmentioning

confidence: 99%

Vascular Normalization as a Therapeutic Strategy for Malignant and Nonmalignant Disease

Goel

Wong

Jain

2011

Cold Spring Harbor Perspectives in Medicine

282

251

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Pathological angiogenesis-driven by an imbalance of pro-and antiangiogenic signaling-is a hallmark of many diseases, both malignant and benign. Unlike in the healthy adult in which angiogenesis is tightly regulated, such diseases are characterized by uncontrolled new vessel formation, resulting in a microvascular network characterized by vessel immaturity, with profound structural and functional abnormalities. The consequence of these abnormalities is further modification of the microenvironment, often serving to fuel disease progression and attenuate response to conventional therapies. In this article, we present the "vascular normalization" hypothesis, which states that antiangiogenic therapy, by restoring the balance between pro-and antiangiogenic signaling, can induce a more structurally and functionally normal vasculature in a variety of diseases. We present the preclinical and clinical evidence supporting this concept and discuss how it has contributed to successful treatment of both solid tumors and several benign conditions.

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Section: Vascular Normalizationmentioning

confidence: 99%

Vascular Normalization as a Therapeutic Strategy for Malignant and Nonmalignant Disease

Goel

Wong

Jain

2011

Cold Spring Harbor Perspectives in Medicine

282

251

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“…iron-laden cells that are found in areas of plaque neovascularization or IPH (88). Therefore, they occupy a distinct microenvironment relative to lipid-laden foam cell macrophages.…”

Section: Ho-1 and Atheroprotective Macrophagesmentioning

confidence: 99%

The Mononuclear Phagocyte System in Homeostasis and Disease: A Role for Heme Oxygenase-1

Hull

Agarwal

George

2014

Antioxidants & Redox Signaling

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Significance: Heme oxygenase-1 (HO-1) is a potential therapeutic target in many diseases, especially those mediated by oxidative stress and inflammation. HO-1 expression appears to regulate the homeostatic activity and distribution of mononuclear phagocytes ( MP) in lymphoid tissue under physiological conditions. It also regulates the ability of MP to modulate the inflammatory response to tissue injury. Recent Advances: The induction of HO-1 within MP-particularly macrophages and dendritic cells-modulates the effector functions that they acquire after activation. These effector functions include cytokine production, surface receptor expression, maturation state, and polarization toward a pro-or anti-inflammatory phenotype. The importance of HO-1 in MP is emphasized by their expression of specific receptors that primarily function to ingest heme-containing substrate and deliver it to HO-1. Critical Issues: MP are the first immunological responders to tissue damage. They critically affect the outcome of injury to many organ systems, yet few therapies are currently available to specifically target MP during disease pathogenesis. Elucidation of the role of HO-1 expression in MP may help to direct broadly applicable therapies to clinical use that are based on the immunomodulatory capabilities of HO-1. Future Directions: Unraveling the complexities of HO-1 expression specifically within MP will more completely define how HO-1 provides cytoprotection in vivo. The use of models in which HO-1 expression is specifically modulated in bone marrow-derived cells will allow for a more complete characterization of its immunoregulatory properties.

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“…The presence of neovascularization in carotid artery plaques is considered as an element of vulnerability because these microvessels are prone to rupture, and IPH has been shown to accelerate plaque evolution [72].…”

Section: The Plaque Neovascularizationmentioning

confidence: 99%

Imaging of the Carotid Artery Vulnerable Plaque

Saba¹,

Anzidei

Marincola

et al. 2013

Cardiovasc Intervent Radiol

106

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Atherosclerosis involving the carotid arteries has a high prevalence in the population worldwide. This condition is significant because accidents of the carotid artery plaque are associated with the development of cerebrovascular events. For this reason, carotid atherosclerotic disease needs to be diagnosed and those determinants that are associated to an increased risk of stroke need to be identified. The degree of stenosis typically has been considered the parameter of choice to determine the therapeutical approach, but several recently published investigations have demonstrated that the degree of luminal stenosis is only an indirect indicator of the atherosclerotic process and that direct assessment of the plaque structure and composition may be key to predict the development of future cerebrovascular ischemic events. The concept of ''vulnerable plaque'' was born, referring to those plaque's parameters that concur to the instability of the plaque making it more prone to the rupture and distal embolization. The purpose of this review is to describe the imaging characteristics of ''vulnerable carotid plaques.''

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Intraplaque Hemorrhage and Progression of Coronary Atheroma

Cited by 1,275 publications

References 33 publications

Vascular Normalization as a Therapeutic Strategy for Malignant and Nonmalignant Disease

Vascular Normalization as a Therapeutic Strategy for Malignant and Nonmalignant Disease

The Mononuclear Phagocyte System in Homeostasis and Disease: A Role for Heme Oxygenase-1

Imaging of the Carotid Artery Vulnerable Plaque

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