Atherosclerosis]

Atherosclerotic lesions can be characterized as accumulation of cholesterol esters and pathologic reactions by various cell groups. The pathogenesis of atherosclerosis has been discussed primarily on the basis of these two phenomena. A well-known concept to explain the etiology of atherosclerosis is the theory of response to injury. According to this theory, physiologically active substances such as platelet-derived growth factor (PDGF) and macrophage colony-stimulating factor (M-CSF) are released in response to injury of the vascular wall, and these substances induce pathologic reactions by the cells constituting the vascular wall. In the presence of excessive amounts of low-density lipoprotein (LDL), denatured LDL modified by oxidation or other reactions on the vascular wall is taken up by macrophages via scavenger receptors, resulting in the formation of foam cells and accumulation of cholesterol esters. Vitamins including Vitamin C and Vitamin E may play an important role in form cell formation by preventing the oxidation.     

Atherosclerosis during adolescence

Interest in diseases of the arteries during the juvenile period is evident during the first half of this century. In the 1950s, it was clearly demonstrated that the early lesions of atherosclerosis were detectable in children and, especially, in adolescents. By the end of the 1960s, the scope of early atherosclerotic changes in the arteries of juveniles became firmly established. In the 1970s, the search for adult risk factors in juveniles began in earnest. In the 1980s, adult risk factors were identified in juveniles and correlated with pathologic changes. The therapeutic issues that involve life-long compliance in high-risk children and adolescents are unique to this age group.     

Molecular MRI of Atherosclerosis

High-resolution MRI is an effective imaging tool for the assessment of atherosclerotic plaques. Although it has been used successfully for the morphological characterization of the atherosclerotic tissue, our ongoing quest to understand the pathobiology of atherogenesis has led to its use in imaging various biological factors involved in plaque initiation, progression, disruption, and regression. Imaging at the molecular and cellular level can play a pivotal role in the diagnosis of atherosclerosis at a preclinical stage and can also enable us to monitor the efficacy of novel anti-atherogenic treatments at the molecular level. This review discusses various methods of molecular MRI for atherosclerosis.     

Atherosclerosis (hypertension)

Many studies have shown that atherosclerosis is an inflammatory disease. Therefore biomarkers reflecting the magnitude of inflammation can be also a good marker for atherosclerosis. Clinical studies have shown that high sensitive C reactive protein (hsCRP) is one of a promising biomarker for presence or progression of atherosclerosis. Markers for dyslipidemia, diabetes, hypertension, and injury of endothelium and smooth muscle cells also have links to atherosclerosis. Regarding hypertension, microalbuminuria and cystatin C levels show the degree of future risk for atherosclerosis. Atherosclerosis is pathologically so complicated that no single biomarker can be perfect and it is essential for every clinician to use several appropriate biomarkers together to diagnose the disease.     

Atherosclerosis in diabetes mellitus

The clinical and epidemiological importance of cardiovascular diseases, has increased rapidly in recent years. Diabetes mellitus which serves as a basis for the development of atherosclerosis, are induced by a genetic predisposition coupled with environmental factors. Hypernutrition and insufficient exercise lead to diabetes mellitus, hyperlipidemia, hypertension, obesity, and insulin resistance in individuals genetically predisposed to these disorders, which eventually produce ischemic heart disease and cerebrovascular disease. The report of the Multiple Risk Factor Intervention Trial (MRFIT) suggested that the prevalence of atherosclerosis in patients with diabetes mellitus is two or three times that in individuals without diabetes, and a Finnish study has reported that the risk of ischemic heart disease is extremely high in patients with type 2 diabetes mellitus. In order to prevent the development of ischemic heart disease in patients with diabetes mellitus, the risks of development of hyperlipidemia, hypertension and other relevant diseases should be carefully controlled.     

抗磷脂综合征与动脉粥样硬化

抗磷脂综合征（antiphospholipid syndrome,APS）是一组以反复发作动、静脉血栓形成、习惯性流产和血小板减少为临床表现,伴有抗磷脂抗体（antiphospholipid antibody,APA）阳性的一种非器官特异性自身免疫性疾病。