Key result
Endothelial-to-mesenchymal transition (EndoMT) is an essential component of the protective barrier in atherosclerotic plaques, though its overall detrimental or beneficial effect remains uncertain.
Why the study?
Whether endothelial-to-mesenchymal transition in atherosclerotic plaques is detrimental by worsening disease progression or beneficial by preventing plaque instability remains uncertain.
This review highlights the complex and uncertain role of endothelial-to-mesenchymal transition in atherosclerotic plaque stability, emphasizing the need for further research to determine if it is a protective or pathological process.
Despite many decades of research, complications of atherosclerosis resulting from the rupture or erosion of unstable plaques remain the leading cause of death worldwide. Advances in cellular lineage tracing techniques have allowed researchers to begin investigating the role of individual cell types in the key processes regulating plaque stability, including maintenance of the fibrous cap, a protective collagen-rich structure that underlies the endothelium. This structure was previously thought to be entirely derived from smooth muscle cells (SMC), which migrated from the vessel wall. However, recent lineage tracing studies have identified endothelial cells (EC) as an essential component of this protective barrier through an endothelial-to-mesenchymal transition (EndoMT), a process that has previously been implicated in pulmonary, cardiac, and kidney fibrosis. Although the presence of EndoMT in atherosclerotic plaques has been shown by several laboratories using EC-lineage tracing mouse models, whether EndoMT is detrimental (i.e., worsening disease progression) or beneficial (i.e., an athero-protective response that prevents plaque instability) remains uncertain as there are data to support both possibilities, which will be further discussed in this review.
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Gole et al. (2022) conducted a review in Atherosclerosis. Endothelial-to-mesenchymal transition (EndoMT) was evaluated. Endothelial-to-mesenchymal transition (EndoMT) is an essential component of the protective barrier in atherosclerotic plaques, though its overall detrimental or beneficial effect remains uncertain.
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