How does LDL get into the artery wall to cause plaque? Many of us used to say that it was damage or holes in the intima - the single-cell lining of the artery wall. Dr. Philip Shaul of UT Southwestern just published an article in Nature magazine indicating that LDL is actually transported through the endothelial cell. The specific enzymes are DOCK4 and SR-B1. This is a general public coverage of the article in Medical Xpress. https://medicalxpress.com/news/2019-04-bad-cholesterol-artery-walls.html This is the link to the actual Nature Magazine article. https://www.nature.com/articles/s41586-019-1140-4/figures/4 What is the impact? It doesn't change much about our understanding of the causes of heart attack & stroke (CV inflammation). or the causes of CV inflammation ( prediabetes, insulin resistance, smoking Lp(a), etc.) But it does create a major opportunity in understanding the specific metabolic pathway associated with LDL deposition in the artery wall. And knowledge of specific metabolic pathways is potentially very powerful - it can lead to prevention and treatment mechanisms previously unknown.
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