Emerging Concepts of Vascular Cell Clonal Expansion in Atherosclerosis

Abstract

Clonal expansion is a process that can drive pathogenesis in human diseases, with atherosclerosis being a prominent example. Despite advances in understanding the etiology of atherosclerosis, clonality studies of vascular cells remain in an early stage. Recently, several paradigm-shifting preclinical studies have identified clonal expansion of progenitor cells in the vasculature in response to atherosclerosis. This review provides an overview of cell clonality in atherosclerotic progression, focusing particularly on smooth muscle cells and macrophages. We discuss key findings from the latest research that give insight into the mechanisms by which clonal expansion of vascular cells contributes to disease pathology. The further probing of these mechanisms will provide innovative directions for future progress in the understanding and therapy of atherosclerosis and its associated cardiovascular diseases.

Keywords: atherosclerosis; cardiovascular diseases; clone cells; macrophages; vascular smooth muscle.

Figure 1.

Smooth muscle cells (SMCs) play an important role in atherosclerotic plaque development. A. SMCs reside within the tunica media of arteries and other blood vessels. B. The clonal expansion of a select few SMCs and the recruitment of monocytes from the bloodstream forms the initial fibrous cap and core respectively. C. SMCs in the cap can migrate into the necrotic core and adopt a macrophage-like phenotype.