Browsing by Author "Kuisma, Jenni"

Cardiovascular diseases (CVDs) are the leading cause of death worldwide and the major cause for them is atherosclerosis. Atherosclerosis is a state of chronic inflammation of the arterial wall, which slowly progresses to form plaques that can eventually obstruct blood flow. The resulting hypoxia in the tissues affected by the ischemia manifests as clinical symptoms such as chest pain. All this begins with chronically high LDL-C concentrations in the blood. LDL-C is transported into the intima of the arterial wall where it is modified with for example oxidizing enzymes. Intimal macrophages remove oxidized LDL via phagocytosis, which leads to lipid accumulation that turns macrophages into foam cells. At first, foam cells die via apoptosis as they are removed by other macrophages. At some point, macrophages cannot remove all the apoptotic material, which leads to a necrotic release of the cell contents. This creates a necrotic core in the center of the atherosclerotic plaque. The inflammatory environment makes vascular smooth muscle cells proliferate and form a fibrous cap to protect the prothrombotic necrotic core. Eventually the plaque can rupture, which leads to the formation of a thrombus and possibly even thrombosis. To prevent this, drugs including statins, ezetimibe and PCSK9 inhibitors are widely used along with certain dietary modifications. More options for diagnosing, preventing, and treating atherosclerosis are still needed to decrease the burden of atherosclerosis and CVDs on both the individual and healthcare systems. A potential example of such methods is presented in this review. This method utilizes synthetic LDL receptors to isolate LDL from the blood, which is needed for determining the quality of LDL particles. The knowledge of LDL quality helps predict the individual risk for developing atherosclerosis.