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Promoting mechanisms of vascular health: circulating progenitor cells, angiogenesis, and reverse cholesterol transport.

Abstract：

:To understand and promote vascular health, we must reduce the aggression to the vessel wall and enhance the physiologic mechanisms leading to restoration of vessel wall function. Three main defense mechanisms are responsible for maintaining cardiovascular homeostasis: the regenerative production of endothelial progenitor cells, vessel wall angiogenesis, and macrophage-mediated reverse cholesterol transport. Endothelial progenitor cells can restore vessel wall function and reduce atherosclerosis. In patients with risk factors, high levels of circulating progenitor cells increase event-free survival from cardiovascular events. Mobilization of progenitor cells includes physical and pharmacological approaches, of which exercise and statin therapy have great potential. Angiogenesis is a pivotal defense mechanism to counteract hypoxia and is needed for plaque regression. However, neovessels are susceptible for intraplaque hemorrhage, particularly in diabetes mellitus. In these patients, the haptoglobin 2-2 genotype is the more affected, and may benefit from an antioxidant approach. Finally, the reverse cholesterol transport system is the main mechanism for plaque regression. In addition to high-density lipoprotein cholesterol, apolipoprotein A-I therapies and the promotion of cholesterol efflux from macrophages by the ABCA1 and ABCG1 transporter systems hold great promise and may be available for therapeutic application in the near future.

journal_name

J Am Coll Cardiol

journal_title

Journal of the American College of Cardiology

authors

Moreno PR,Sanz J,Fuster V

doi

10.1016/j.jacc.2009.02.057

subject

Has Abstract

pub_date

2009-06-23 00:00:00

pages

2315-23

issue

25

eissn

0735-1097

issn

1558-3597

pii

S0735-1097(09)01121-8

journal_volume

53

pub_type

杂志文章,评审

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