T cell subsets and functions in atherosclerosis

Abstract

Atherosclerosis is a chronic inflammatory disease of the arterial wall and the primary underlying cause of cardiovascular disease. Data from in vivo imaging, cell-lineage tracing and knockout studies in mice, as well as clinical interventional studies and advanced mRNA sequencing techniques, have drawn attention to the role of T cells as critical drivers and modifiers of the pathogenesis of atherosclerosis. CD4 + T cells are commonly found in atherosclerotic plaques. A large body of evidence indicates that T helper 1 (T H 1) cells have pro-atherogenic roles and regulatory T (T reg ) cells have anti-atherogenic roles. However, T reg cells can become pro-atherogenic. The roles in atherosclerosis of other T H cell subsets such as T H 2, T H 9, T H 17, T H 22, follicular helper T cells and CD28 null T cells, as well as other T cell subsets including CD8 + T cells and γδ T cells, are less well understood. Moreover, some T cells seem to have both pro-atherogenic and anti-atherogenic functions. In this Review, we summarize the knowledge on T cell subsets, their functions in atherosclerosis and the process of T cell homing to atherosclerotic plaques. Much of our understanding of the roles of T cells in atherosclerosis is based on findings from experimental models. Translating these findings into human disease is challenging but much needed. T cells and their specific cytokines are attractive targets for developing new preventive and therapeutic approaches including potential T cell-related therapies for atherosclerosis. Accumulating evidence supports the critical role of T cells as drivers and modifiers of atherosclerosis. In this Review, Ley and colleagues describe the latest advances in our understanding of the role of T cell subsets in atherosclerosis, discuss the process of T cell homing to atherosclerotic plaques and highlight potential T cell-related therapies for atherosclerosis. Atherosclerosis is a chronic inflammatory disease, and accumulating evidence supports the critical role of T cells as drivers and modifiers of this condition. T cells drive immune responses to peptide epitopes related to atherosclerosis, such as peptides derived from apolipoprotein B. CD4 + T helper 1 (T H 1) cells and natural killer T cells have pro-atherogenic properties, whereas regulatory T (T reg ) cells have anti-atherogenic functions. The role of other T H cell subsets, such as T H 2, T H 9, T H 17, T H 22 and follicular helper T (T FH ) cells, and of CD8 + T cells and γδ T cells, in the development and progression of atherosclerosis remains controversial. During atherosclerosis progression, T reg cells can convert into pro-inflammatory T cell subsets, such as T H 1, T H 17 or T FH cells. T cell recruitment to the atherosclerotic plaque occurs via chemokines and chemokine receptors such as CC-chemokine receptor 5 (CCR5), CXC-chemokine receptor 3 (CXCR3) and CXCR6.