WHAT CAN WE LEARN FROM SPECIMENS OF CAROTID ARTERIES
Piťha J.1, Bartušková H.2
1Department of Cardiology, Centre for Cardiovascular Research, Institute for Clinical and Experimental Medicine, Prague
2Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague
Atherosclerotic plaques can develop differently in different locations. Many factors such as gender, age, comorbidities and external forces can further influence plaque vulnerability. To refine the diagnosis and stratification of vulnerable patients, in vivo imaging techniques need to be validated for full substitution of histological markers. Endarterectomy specimens represent a unique opportunity to study atherosclerosis and, potentially, to validate some imaging methods. Despite the significant advancement of in vivo imaging techniques, the stroke prediction based on carotid artery plaque morphology is not reliable, not to mention the prediction of other vascular events. Besides analyses of plaque morphology, present studies focus on precise characterization of the plaque composition, including different immune cell types and elucidation of their role in plaque development and stability/vulnerability to cause clinical events such as strokes. Plaque content analyses revealed the presence of various immune cells in carotid artery plaques, and the presence of different subpopulations of immune cells can be connected to undesirable changes in plaque stability.
In summary, since the destabilization of the atherosclerotic plaque is a multifactorial process, a combination of various methods should be used to characterize the unstable plaques more accurately. In this context, studies characterizing plaque content from a cellular point of view could elucidate some processes underlying the plaque progression. Together with morphological evaluation, these analyses could enable more precise assessment of plaque stability. Additionally, analysis of parts of the vessel wall adjacent to carotid plaque could reveal information valuable for the assessment of the general status of vasculature in a given patient.
The presentation will summarize the recent knowledge of atherogenesis from studies characterizing a cellular composition of carotid endarterectomy specimens including our results and future directions of research, exploitation of these methods in clinical practice.
Supported by MH CZ – DRO (“Institute for Clinical and Experimental Medicine – IKEM, IN 00023001”)