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(Circulation Research. 2000;86:715.)
© 2000 American Heart Association, Inc.

Editorial

Lipoprotein Effects on the Vessel Wall

Michael B. Stemerman

From the Department of Biomedical Sciences, University of California, Riverside, Calif.

Correspondence to Michael B. Stemerman, Division of Biomedical Sciences, B605 Statistics Road, University of California, Riverside, CA 92521-0121. E-mail michael.stemerman@ucr.edu

Key Words: lipoproteins • VLDL • LDL • HDL • endothelium

	Introduction

 
Accumulation of lipids within the arterial wall is a distinguishing characteristic of the atherosclerotic lesion and is seen in virtually all stages of plaque development. This process is directly correlated with the serum level of some lipids, especially cholesterol, LDL, and other lipoprotein particles. In contrast, an increased serum level of HDL is protective against plaque formation. Evidence has steadily accumulated showing that HDL acts as a "sink" for cholesterol, presumably removing it from tissue. In any discussion of trafficking of materials between blood and the arterial wall, the endothelium must be considered pivotal because of its critical location at the junction between blood and blood vessel. Penetration of lipoproteins into the arterial wall has been shown both quantitatively and qualitatively in experimental animal models. Areas of lipid accumulation appear at localized sites along the arterial lumen in these animal models, consistent with the focal nature of plaque development in humans. The mechanism for the predilection of some localized areas to accumulate plaque has been under debate for a considerable time and is likely multifactorial. In some instances, this process seems related to a focal transient loosing of the tight association between adjoining endothelial cells (ECs). In these areas, there may be easy access to underlying vascular tissue. However, because such gaps appear only occasionally, it is likely that some ECs are actively involved in the accumulation of lipids.¹ These topics are at the center of the study by Rutledge et al² described in this issue of Circulation Research.

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