Atherosclerosis; hypotheses of atherogenesis
Chapter: 10
- insudation: The lipid in the atheroma is derived from the blood through a process of insudation and deposition in the intima.
- encrustation: Small mural thrombi are the initial event, with subsequent organization and expansion.
- reaction to injury: Smooth muscle proliferation occurs in response to growth factors released by platelets and macrophages, e.g.,PDGF (Platelet derived growth factor).
- monoclonal hypothesis: The smooth muscle proliferation seen in atherosclerosis appears to be monoclonal, and suggests that some unknown factor such as viruses may induce atherosclerosis by altering growth control in the smooth muscle cells.
- intimal cell mass hypothesis: These are focal accumulation of smooth muscle cells in normal vascular intima at branch points, ( ? congenital problem ?) which may represent the early lesion or a precursor of atherosclerosis.
- hemodynamic hypotheses: Certain hemodynamic changes may enhance the process of atherosclerosis e.g. the role of hypertension.
- unifying hypothesis: Incorporates all of the above.
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