The influence of extracellular matrix composition on the pathogenesis of coronary atherosclerosis

Abstract

The modern concept of the development of atherosclerosis implies that the underlying pathogenesis of this disease is vascular remodeling as a response of the vessel wall to hypertension associated with hyperlipidemia and subsequent inflammation. However, even though this disease has been investigated for decades, both from a basic and clinical research aspect, there are still many doubts as to what the initial phase of the disease is. In contemporary literature there are an increasing number of papers that stress the importance of the extracellular matrix (ECM) of the blood vessels connective tissue, particularly proteoglycans, in the formation of early atherosclerotic lesions of human coronary arteries

Modern view on the structure of the vascular extracellular matrix

“…Endothelial cells are firmly attached to a basement membrane and subendothelial tissue through their cytoskeleton and integrins bonds. These contacts enable the information transfer between connective tissue matrix and integrins on one side and cytoskeleton and nuclei of endothelial cell on the other (5,6). Hence, the information from "outside" can induce either synthesis or degradation of extracellular matrix proteins, control the degree of integrins expression, transduction of signals that can lead to enhanced growth, motility and proliferation of the endothelial cells, as well as regulation of the inflammation (7)(8)(9).…”