Immunological hypothesis of atherosclerosis

During the past decade, several novel risk factors for atherosclerosis including inflammation and infections, have been reported. Recent data suggest that the initial stages of atheroclerosis are of immunologic nature. There is evidence of an autoimmune reaction of specific T-cells against heat shock proteins expressed on the surface of endothelial cells, which are exposed to hemodynamic stress. Humoral and cellular immune mechanisms can be determined in the early subclinical stages of the disease. This immune process can be found even in children and is reversible in the absence of other risk factors. In the presence of hypertension, hypercholesterolemia and other risk factors it becomes irreversible and enables the formation of atherosclerotic deposits with all the pathohystologic and functional consequences.