Although vascular remodeling is an important determinant in many physiological processes, it is also observed in vascular pathologies. Changes in both cellular and noncellular components are critical for remodeling of the vascular wall. Depending on the pathological process, smooth muscle cell (SMC) growth and migration, entodothelial cell (EC) dysfunction, inflammatory cell infiltration, extracellular matrix degradation, or synthesis can occur. Atherosclerosis is a complex, progressive disease of the large arteries and the leading cause of death in the Western world. Recent research has shown the crucial role of leukocytes in the development and progression of atherosclerotic lesions.
Immune cells are already present in early lesions, and advanced plaques show large lipid cores in which macrophages are often present. Recent evidence has revealed considerable diversity in the monocyte and macrophage populations present in the atherosclerotic plaques. The impact of the different macrophage phenotypes (e.g., M1 and M2) in plaque progression and instability is just beginning to be investigated.
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