Factors in Formation and Regression of the Atherosclerotic Plaque: Proceedings of a NATO Advanced Study Institute on the Formation and Regression of the Atherosclerotic Plaque, held September 3–13, 1980, in Belgirate, Italy

258 Pages·1982·6.825 MB·English

by  Giorgio Weber (auth.), Gustav R. V. Born, Alberico L. Catapano, Rodolfo Paoletti (eds.)

Factors in Formation and
Regression of the
Atherosclerotic Plaque
NATO ADVANCED STUDY INSTITUTES SERIES
A series of edited volumes comprising multifaceted studies of contem
porary scientific issues by some of the best scientific minds in the
world, assembled in cooperation with NATO Scientific Affairs
Division.
Series A: Life Sciences
Recent Volumes in this Series
Volume 43 - Advanced Topics on Radiosensitizers of Hypoxic Cells
edited by A. Breccia, C. Rimondi, and G. E. Adams
Volume44-Cell Regulation by Intracellular Signals
edited by Stephane Swillens and Jacques E. Dumont
Volume 45 - Structural Molecular Biology: Methods and Applications
edited by David B. Davies, Wolfram Saenger, and Steven S. Danyluk
Volume 46 - Post-Harvest Physiology and Crop Preservation
edited by Morris Lieberman
Volume 47-Targeting of Drugs
edited by Gregory Gregoriadis, Judith Senior, and Andre Trouet
Volume 48-Neurotransmitter Interaction and Compartmentation
edited by H. F. Bradford
Volume 49-Biological Effects and Dosimetry of Nonionizing Radiation
edited by Martino Grandolfo, Sol M. Michaelson, and Alessandro Rindi
Volume 50-Somatic Cell Genetics
edited by C. Thomas Caskey and D. Christopher Robbins
Volume 51-Factors in Formation and Regression of the Atherosclerotic Plaque
edited by Gustav R. V. Born, Alberico L. Catapano, and
Rodolfo Paoletti
Volume 52-Chemical Carcinogenesis
edited by Claudio Nicolini
This series is published by an international board of publishers in con
junction with NATO Scientific Affairs Division
A Life Sciences Plenum Publishing Corporation
B Physics London and New York
C Mathematical and D. Reidel Publishing Company
Physical Sciences Dordrecht, The Netherlands
and Hingham, Massachusetts, USA
D Behavioral and Martinus Nijhoff Publishers
Social Sciences The Hague, The Netherlands
E Applied Sciences
Factors in Formation and
Regression of the
Atherosclerotic Plaque
Edited by
Gustav R. V. Born
University of London King's College
London, England
and
Alberico L. Catapano
Rodolfo Paoletti
Institute of Pharmacology and Pharmacognosy
University of Milan
Milan, Italy
PLENUM PRESS • NEW YORK AND LONDON
Published in cooperation with NATO Scientific Affairs Division
Library of Congress Cataloging in Publication Data
Main entry under title:
Factors in formation and regression of the atherosclerotic plaque.
(NATO advanced study institutes series. Series A, Life sciences; v. 51)
"Proceedings of a NATO Advanced Study Institute on the Formation and Regression
of the Atherosclerotic Plaque, held September 3-13, 1980, in Belgirate, Italy"-Verso
t.p.
"Published in cooperation with NATO Scientific Affairs Division."
Bibliography: p.
Includes index.
1. Atherosclerosis - Congresses. 2. Atherosclerosis - Etiology - Congresses. I. Born,
G. R. V. II. Catapano, Alberico L. III. Paoletti, Rodolfo. IV. NATO Advanced Study
Institute on the Formation and Regression of the Atherosclerotic Plaque (1980):
Belgirate, Italy) V. North Atlantic Treaty Organization. Scientific Affairs Division. VI.
Series. [DNLM: 1. Arteriosclerosis - Etiology - Congresses. 2. Arteriosclerosis
Metabolism-Congresses. WG 550 N2798f 1980]
RC692.F31982 616.1'36 82-10132
ISBN-13: 978-1-4684-4270-0 e-ISBN-13: 978-1-4684-4268-7
DOl: 10.1007/978-1-4684-4268-7
Proceedings of a NATO Advanced Study Institute on the Formation
and Regression of the Atherosclerotic Plaque, held September 3-13,
1980, in Belgirate, Italy
© 1982 Plenum Press, New York
Softcover reprint of the hardcover 1s t edition 1982
A Division of Plenum Publishing Corporation
233 Spring Street, New York, N.Y. 10013
All rights reserved
No part of this book may be reproduced, stored in a retrieval system, or transmitted,
in any form or by any means, electronic, mechanical, photocopying, microfilming,
recording, or otherwise, without written permission from the Publisher
PREFACE
Interest in the field of atherosclerosis research has
broadened in recent years. However the main focus remains on the
physiopathology of the arterial wall and on its interaction with
blood constituents.
The purpose of this NATO Advanced Study Institute on "Factors
in Formation and Regression of the Atherosclerotic Plaque" was to
discuss the following points:
a) The physiopathology of the arterial wall;
b) Animal models;
c) Methods of studying the progression and regression of
atherosclerotic lesions quantitatively;
d) The role of lipoproteins, platelets, smoke, alcohol,
etc. in the formation of atherosclerotic lesions;
e) The pharmacological and dietary control of "risk factors."
This volume is a collection of the most relevant presentations
on these topics. We hope it will provide a background for young
scientists as well as a stimulus for further research to biologists
and clinicians.
We wish to acknowledge the support of NATO and the Nutrition
Foundation of Italy in organizing this Advanced Study Institute.
Gustav R. V. Born
Alberico L. Catapano
Rodolfo Paoletti
v
CONTENTS
PHYSIOLOGY AND PATHOLOGY OF THE ARTERIAL WALL
Morphology and Physiology of the Arterial Wall • • . • • 1
Giorgio Weber
Metabolism of the Arterial Wall 21
Elspeth B. Smith
Aortic Lipid Metabolism 35
David Kritchevsky
From the Fatty Streak to the Calcified Lesion 45
Elspeth B. Smith
Progression and Regression of Advanced Atherosclerosis
as Studied by Quantitative Methods ••••.• 59
Robert W. Wissler
Ultrasound Techniques in the Study of Carotid Artery
Atheroma • • . • . • • • • 79
Robert J. Lusby
ANIMAL MODELS
Experimental Atherosclerosis: Diet and Drugs 95
David Kritchevsky
On the Selection of Animal Species as Models for Atherosclerosis
Research, with Particular Reference to the
Common Marmoset (Callithrix jacchus) 107
M. John Chapman, Patricia Forgez, Sonia Goldstein,
and Fergus McTaggart
vii
viii CONTENTS
LIPOPROTEINS AND ATHEROSCLEROSIS
Smooth Muscle Metabolic Reactivity in Atherogenesis:
LDL Metabolism and Response to Serum Mitogens
Differ According to Phenotype 115
Julie H. Chamley-Campbell, Paul Nestel," and
Gordon R. Campbell
Thermodynamics and Mechanism of the Association of Plasma
Apolipoproteins with Synthetic Phosphatidylcholines.. 125
H. J. Pownall, J. B. Massey, and A. M. Gotto Jr.
Metabolic Fate of 3H-Cholesteryl Linoleyl Ether, a
Nondegradable Analog of Lipoprotein Cholesteryl
Ester . • . • • • • • .. • • . • • . • . 139
Yechezkiel Stein, Olga Stein, and Gideon Halperin
Interactions between Lipoproteins and Glycosaminoglycans 155
A. L. Catapano, E. Tr.e zzi, and R. Fumagalli
Plasma Lipoprotein Changes Induced by Diets and Drugs 163
Cesare R. Sirtori
PLATELETS AND ATHEROSCLEROSIS
Endogenous Agents in Platelet Thrombosis 197
G. V. R. Born and M. A. A. Kratzer
Platelet and Vascular Prostaglandins in Uraemia,
Thrombotic Microangiopathy and Pre-Eclampsia 209
G. de Gaetano, M. Livio, M. G. Donati,
and G. Remuzzi
Pharmacological and Dietary Control of Platelet Vessel
Wall Interactions in Normal and Pathological
Conditions ................. . 217
Elena Tremoli, C. Galli, and R. Paoletti
OTHER FACTORS IN PROGRESSION AND REGRESSION
Tobacco Smoking and Atherosclerosis 243
Constantin J. Miras
Ethanol and Blood Lipids in Man ••••••. 255
Pietro Avogaro, G. Bittolo-Bon, F. Belussi,
and G. Cazzolato
Index 263
MORPHOLOGY AND PHYSIOLOGY OF THE ARTERIAL WALL
Giorgio Weber
Institute of Pathologic Anatomy, Center of Research on
Atherosclerosis, University of Siena, Siena, Italy
I) STRUCTURAL DIFFERENCES OF ARTERIES IN DIFFERENT BODY DISTRICTS
Correlations between Anatomy and Physiology on one side, Pa
thology of the wall and of the organs on the other are not well de
veloped. It's common clinical observation in our countries that myo
cardial infarction concerns younger people and cerebral infarction ,
older people. We also know that different risk factors may be at the
basis of these age difference or different pathological lesions at
arterial wall level or even different structural and functional char
acteristics of these arterial districts.
In order to give a morphological basis to these and other similar
clinical observations, a pluridistrictual morphological study is re
quired, extended to all or most of the arterial tree,a task which is
only at its beginning in humans as well as in most common animal mod
els. In effect though in the last century and also more recently
comparisons of lesions and their degree have been performed, for
instance on superior and inferior limb arteries, not much is known
in structural differences which could induce also different patholog
ical patterns of lesions. Only from 1977 myocardial infarct and cere
bral infarct experts began meeting regularly and exchanging their
experiences! I do think that comparison of orthologic structures and
pathologic lesions in different body districts will give results in
the future. In Italy, a National Research Council Special Program is
on since four years.
Morbid Anatomic (postmortem) observation allows comparison among
structure and lesions in different body districts: two figures, from
2 GIORGIO WEBER
the autopsy of a 22 years old woman dead because of a sub-arachnoidal
hemorrhage (Siena,aut 8759/12), show the descending branch of the
left coronary artery and the left middle cerebral artery: in the
coronary the" diffuse intimal thickening" \DIT) is well evident,
in the cerebral artery no signs of diffuse intimal thickening are
found. These different features in coronary and cerebral arteries
can well explain the earlier development of arterial lesion in the
coronaries and the earlier appearance of organ lesions in the heart.
The question is anyway still unsettled, as you know, on the
significance of DIT which has been studied so far practically only
at heart coronary level(review by Geer and Haust,1972 and more re
cently by Haust,1980) and to whiqh a significant contribution has
been given by D. and C. Velican (1978). Little information is avai
lable in recent literature on the histology of diffuse intimal thick
ening at different ages in normal aorta not only in man but also in
non-human primates or in other animal models, actually used in athero
sclerosis research.
Some observations are collected in a study by stout and Thorpe
(1980) on the aorta of non-human primates where the DIT did not ap
pear prevalent or more evident in any particular aortic area, so
that its distribution did not provide any clue as to its etiology
and as to its eventual pathogenic implications. At any rate, the
growth of DIT resulted accomplished by the addition of smooth mus
cle cells (SMCs) at the intimal medial junction.
It is not clear at all if and how those findings may be related
to the "intimal SMC masses" observed in the abdominal aorta of young
swine by Scott et al.(1979). Those masses are located predominantly
away from the blood vessel orifices; they appear more frequently
dorsally located in distal half of the abdominal aorta, ventrally
in the proximal half. The Authors observed early appearance of athe
rosclerosis (ATS) experimental lesions in corrispondence of those
cushions of SMCs. More subtle differences between aortic and abdominal
segments have been pointed out by Goldberg et al.(1980) who observed
greater myointimal proliferation in abdominal than in thoracic aorta
in rabbits subjected to intimal injury: it must be noted that the
regional variations observed in response to injury take place in
SMCs "which are phenotypically similar". And let us remind here that
Haley et al.(1977) documented at least two different populations of
SMCs in atherosclerotic lesions.
In cerebral arteries, areas of intimal muscular proliferation,
focally located near the orifices of the large distributing arteries,
have been described by Stehbens (1960) by means of serial arterial
MORPHOLOGY AND PHYSIOLOGY OF THE ARTERIAL WALL 3
1
2
Fig. 1-2. Woman 22 years old (aut. 8759/12 Siena): no sign of diffuse
intimal thickening (well evident instead in the left descend
ing coronary artery,2) in the left cerebral artery (1).