Into to atherosclerosis Flashcards
What are the functions and properties of the endothelial cells?
- Maintenance of permeability barrier
- Elaboration of molecules that modulate coagulation
- Extracellular matrix production
- Modulation of blood flow and vascular reactivity
- Regulation of inflammation and immunity
- Regulation of cell growth
- Oxidation of LDL
What are the anticoagulant molecules produced by endothelial cells?
- Prostacyclin
- Thrombomodulin
- Heparin-like molecules
- Plasminogen activator
What are the prothrombotic molecules produced by endothelial cells?
- Von willebrand factor
- Tissue factor
- Plasminogen activator inhibitor
What are the vasoconstrictors produced by endothelial cells?
Endothelin, angiotensin converting enzyme
What are the vasodilators produced by endothelial cells?
Nitric oxide and prostacyclin
What are the molecules involved in inflammation and immunity of endothelial cells?
IL-1, IL-6, chemokines, adhesion molecules, histocompatability antigens
What are the cell growth stimulators produced by endothelial cells?
Platelet derived growth F, colony stimulating factor, fibroblast growth factor
What are the cell growth inhibitors produced by endothelial cells?
heparin, transforming growth factor-B
What are some of the effects of LDL modifications?
- Increased adhesion molecule expression
- Expression of chemokines, Ck receptors
- Amplification of platelet activation
What are some of the LDL modifications that promote LDL to be taken in by scavenger receptors and therefore remain in the periphery/hepatocytes?
Lipid oxidation, ApoB fragmentation, Glycation, Immune complexes
During leukocyte recruitment, what are some of the selectins involved with rolling?
LFA-1/ICAM-1
During leukocyte recruitment, what are some of the selectins involved with arrest?
- LFA-1/ICAM-1
- VLA4/VCAM1
- MAC-1/ICAM-1
During leukocyte recruitment, what are some of the selectins involved with adhesion strengthening?
VAV1, VAV3, PI3Kgamma, SCR kinases
During leukocyte recruitment, what are some of the selectins involved with crawling?
- MAC-1/ICAM-1
- LFA-1/ICAM-1
During transmigration, what are some of the selectins involved with transmigration?
- PECAM-1
- LFA-1/JAM-A
- CD99
- ESAM
During intimal/medial thickening and response to vascular injury, what are some of the proliferative factors involved?
PDGF-BB, IGF-1, bFGF, TGF-b, EGF, ANGII
During neointima formation, what are some of the characteristics that occur in this process?
- Change in smooth muscle phenotype
- Lose contractility
- Grain proliferative and migratory capacity
- Gain synthetic capacity: Extracellular matrix
- Fibroblast proliferation and collagen production
What are the constituents of the fibrous cap in an atheroma?
- Smooth muscle cells
- macrophages
- Foam cells
- Lymphocytes
- Collagen
- Elastin
- Proteoglycans
- neovascularization
What are some of the constituents of the necrotic center in an atheroma?
Cell debris, cholesterol crystals, foam cells, calcium
What are some of the characteristics of a complicated lesion?
- Advanced lesion
- Patchy or massive calcification
- Focal rupture or ulceration of luminal surface (exposure of thrombogenic constituents/atheroembolization)
- Intra-plaque hemorrhage
- Superimposed thrombosis
- Weakening of tunica media (thinning of tunica media, loss of elastic tissue with aneurysmal dilation
Assemble the following in order of highest incidence of atherosclerosis to lowest: Internal carotids, descending thoracic aorta, circle of willis, abdominal aorta, popliteal arteries, coronoary arteries
- Abdominal aorta
- Coronary arteries
- Popliteal arteries
- Descending thoracic aorta
- Internal carotids
- Circle of Willis
What are the modifiable risk factors for atherosclerosis?
- Smoking
- HTN
- Dyslipidemia-high LDL/low HDL
- DM/ Metabolic syndrome
- Sedentary lifestyle
What are the nonmodifiable risk factors for atherosclerosis
- Age
- Sex
- Family Hx-genetics
