Local proliferation dominates lesional macrophage accumulation in atherosclerosis
Open accessAbstract
During the inflammatory response that drives atherogenesis, macrophages accumulate progressively in the expanding arterial wall. The observation that circulating monocytes give rise to lesional macrophages has reinforced the concept that monocyte infiltration dictates macrophage buildup. Recent work has indicated, however, that macrophage accumulation does not depend on monocyte recruitment in some inflammatory contexts. We therefore revisited the mechanism underlying macrophage accumulation in atherosclerosis. In murine atherosclerotic lesions, we found that macrophages turn over rapidly, after 4 weeks. Replenishment of macrophages in these experimental atheromata depends predominantly on local macrophage proliferation rather than monocyte influx. The microenvironment orchestrates macrophage proliferation through the involvement of scavenger receptor A (SR-A). Our study reveals macrophage proliferation as a key event in atherosclerosis and identifies macrophage self-renewal as a therapeutic target for cardiovascular disease.
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Atherosclerosis is the most likely cause of myocardial infarction and stroke.
“Atherosclerosis is the most likely cause of MI and stroke [12–15].”
From Cardiovascular disease models: A game changing paradigm in drug discovery and screening (2019) · cites this paper as [15]
Studies in animal models have collectively revealed an essential requirement for macrophages in the progression of atherosclerosis, likely involving effects on VSMC migration, proliferation and phenotype switching.
“Studies in animal models have collectively revealed an essential requirement for macrophages in the progression of atherosclerosis 120,122,127,128 , which is likely to involve effects on VSMC migration, proliferation (through production of factors such as PDGF 129 ) and phenotype switching 130 .”
From Vascular smooth muscle cells in atherosclerosis (2019) · cites this paper as [120]
Lineage tracing studies have shown that macrophage marker-positive cells of early lesions in mice (which resemble intimal xanthomas) are mostly derived from recruited circulating monocytes, and may also involve local resident macrophages.
“Lineage tracing studies have xanthomas) are mostly derived from recruited circulating monocytes 23,120 , and may also involve local resident macrophages 121,122 .”
From Vascular smooth muscle cells in atherosclerosis (2019) · cites this paper as [120]
In atherosclerotic mice, when monocyte influx is limited or absent, proliferation of existing lesional macrophages can account for macrophage replenishment and possibly for increased macrophage numbers in advanced plaques.
“First, if only limited or no influx of monocytes into the lesions occurs, the proliferation of the already existing lesional macrophages can explain the macrophage replenishment that is observed in the lesions and possibly also the increase in macrophage numbers seen in advanced atherosclerotic plaques163.”
From Inflammation and its resolution in atherosclerosis: mediators and therapeutic opportunities (2019) · cites this paper as [163]
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Efficacy and limitations of senolysis in atherosclerosis
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“Macrophages in atherosclerosis arise from both migration from the bone marrow via peripheral blood and proliferation of resident macrophages.(20) In addition, previous studies demonstrated that foam cells expressing p16-3MR can be removed from atherosclerotic plaques by GCV.”
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Atherosclerosis in the single-cell era
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- Authors
- Robbins, C. S., Hilgendorf, I., Weber, G. F., Theurl, I., Iwamoto, Y., Figueiredo, J.-L., Gorbatov, R., Sukhova, G. K., Gerhardt, L. M. S., Smyth, D., Zavitz, C. C. J., Shikatani, E. A., Parsons, M., van Rooijen, N., Lin, H. Y., Husain, M., Libby, P., Nahrendorf, M., Weissleder, R., & Swirski, F. K.
- Affiliations
- University Health Network (CA)
- Harvard University (US)
- Brigham and Women's Hospital (US)
- Mount Sinai Hospital (CA)
- Corresponding author
- Robbins, Clinton S
- ORCID
- Venue
- Nature Medicine
- Published
- 2013-08-11
- Volume
- 19
- Issue
- 9
- Pages
- 1166-1172
- ISSN
- 1078-8956 (ISSN-L)
- 1546-170X
- PMC
- PMC3769444
- OpenAlex
- W2031047943
- Cited by
- 1,041
- References
- 42
- Citations by year
- 2026: 34 · 2025: 57 · 2024: 64 · 2023: 87 · 2022: 80 · 2021: 86 · 2020: 67 · 2019: 78 · 2018: 83 · 2017: 81 · 2016: 109 · 2015: 104 · 2014: 97 · 2013: 13
- FWCI
- 59.59
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Medicine (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- Pure Amsterdam UMC (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- U.S. Public Health Service (P01 A154904, HHSN 268201000044C)
- National Heart, Lung, and Blood Institute (HHSN268201000044C, R01HL095612)
- National Cancer Institute (P50CA127003, U24CA092782, P50CA086355)
- National Institute of Allergy and Infectious Diseases (P01AI054904)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK071837, R01DK069533)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cerebrovascular and Carotid Artery Diseases
- Keywords
- atherosclerosis, macrophage proliferation, monocyte recruitment, scavenger receptor A, macrophage self-renewal, macrophage turnover, atherosclerotic plaque, macrophage accumulation, therapeutic target
- MeSH terms
- Animals, Cells, Cultured, Inflammation, Macrophages, Mice, Inbred C57BL, Monocytes, Mice, Knockout, Cell Proliferation, Atherosclerosis, Mice
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