Ney Carter Borges: Cholesterol-Inflammation Fusion in Atherosclerosis
Ney Carter Borges, Member Cardiologist of Global Physician Association at Cleveland Clinic Florida, shared a post on LinkedIn:
“Cholesterol–Inflammation Fusion in Atherosclerosis
Key mechanistic pathway
1. LDL infiltration
Circulating LDL penetrates the vascular intima and undergoes oxidative modification forming oxidized LDL (ox-LDL).
2. Macrophage lipid uptake
ox-LDL binds scavenger receptors (e.g., CD36) leading to macrophage lipid accumulation and foam-cell formation.
3. Cholesterol crystal formation
Excess intracellular cholesterol crystallizes, causing lysosomal rupture and activation of the NLRP3 inflammasome.
4. Inflammatory cascade
Inflammasome activation promotes IL-1β, IL-6 and TNF-α release, amplifying vascular inflammation.
5. Disruption of cholesterol efflux
Cytokines suppress ABCA1 and ABCG1 transporters, impairing HDL-mediated cholesterol removal.
6. Self-perpetuating loop
Reduced cholesterol efflux increases lipid accumulation, further activating inflammatory pathways and accelerating plaque progression.
This bidirectional cycle between lipid dysregulation and vascular inflammation constitutes the cholesterol-inflammation fusion loop, a key mechanism driving plaque progression and instability in atherosclerotic cardiovascular disease.”
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