Development of the Lipid-Rich Core in Human Atherosclerosis

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Presentation transcript:

Development of the Lipid-Rich Core in Human Atherosclerosis by John R. Guyton, and Keith F. Klemp Arterioscler Thromb Vasc Biol Volume 16(1):4-11 January 1, 1996 Copyright © American Heart Association, Inc. All rights reserved.

Photomicrograph shows early formation of atherosclerotic core demonstrated in frozen section of a small fibrolipid lesion from human aorta (lumen at top). Photomicrograph shows early formation of atherosclerotic core demonstrated in frozen section of a small fibrolipid lesion from human aorta (lumen at top). The core (thin arrow), which has a hazy appearance by oil red O staining, is found in the musculoelastic, deeper sublayer of the intima. Internal elastic lamina is indicated by the open arrow. Foam cell infiltrates, staining densely with oil red O, appear in the more superficial intimal sublayer at the shoulders of this lesion (near both sides of micrograph). The difference in staining characteristics reflects the differing compositions of core lipids, mostly cholesterol-rich vesicles, and foam cell lipids, mostly cholesteryl ester–rich oily droplets. (Photomicrograph courtesy of T.M.A. Bocan, Warner-Lambert Co. Magnification ×800.)‏ John R. Guyton, and Keith F. Klemp Arterioscler Thromb Vasc Biol. 1996;16:4-11 Copyright © American Heart Association, Inc. All rights reserved.

Plot shows ratios of area occupied by vesicles to area occupied by oily droplets in cores of mature human aortic fibrous plaques. Plot shows ratios of area occupied by vesicles to area occupied by oily droplets in cores of mature human aortic fibrous plaques. Each point represents a subregion within the core; points are plotted according to whether cholesterol clefts were present in the subregion. The variability of core appearance in these mature lesions should be noted, as well as the association of cholesterol clefts (crystals) with vesicular lipid deposits. (Reprinted with permission from Guyton JR, Klemp KF. Am J Pathol. 1990;134:771.)‏ John R. Guyton, and Keith F. Klemp Arterioscler Thromb Vasc Biol. 1996;16:4-11 Copyright © American Heart Association, Inc. All rights reserved.

Plot shows mole fractions of total cholesterol measured in the free (unesterified) form in fatty streaks and microdissected cores of small raised lesions (fibrolipid lesions) and large raised lesions (fibrous plaques). Plot shows mole fractions of total cholesterol measured in the free (unesterified) form in fatty streaks and microdissected cores of small raised lesions (fibrolipid lesions) and large raised lesions (fibrous plaques). Note that cholesteryl ester is abundant in fatty streaks but the early fibrolipid core has mostly free cholesterol. The fibrous plaque core has a variable lipid composition, consistent with the variable ultrastructural appearance quantified in Fig 2. (Adapted from Guyton and Klemp.19 )‏ John R. Guyton, and Keith F. Klemp Arterioscler Thromb Vasc Biol. 1996;16:4-11 Copyright © American Heart Association, Inc. All rights reserved.