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Significance of the adaptive immune response in the progression of atherosclerosis

Alexander V. Blagov, Vasily N. Sukhorukov, Mikhail A. Popov, Andrey V. Grechko, Alexander N. Orekhov

Atherosclerosis is a chronic inflammatory disease of the arterial wall and a major cause of cardiovascular disease. Approaches including in vivo imaging, cell line tracing and knockout studies in mice, as well as clinical intervention studies and advanced mRNA sequencing techniques have drawn attention to the role of T-cells and B-cells as critical factors and modifiers in the pathogenesis of atherosclerosis. CD4+ T-cells are commonly found in atherosclerotic plaques. A large body of evidence indicates that T-helper cells 1 (Th-1) play a pro-atherogenic role and regulatory T-cells (T-reg) play an antiatherogenic role. However, T-reg cells in some conditions can become proatherogenic. The role in atherosclerosis of other Th subsets of cells, such as Th-2, Th-17, follicular helper T-cells, as well as CD8+ T-cells and γδ T-cells, is less understood. B-cells perform both atheroprotective and proatherogenic functions. While B1 cells and marginal zone B-cells are considered protective against atherosclerosis, follicular B-cells and innate response activator B-cells have been shown to promote atherosclerosis.