CHARLOTTESVILLE, Va. — Researchers have created an “atlas” that can map out the arterial hardening that leads to heart disease and strokes. A team at the University of Virginia School of Medicine are showing how the tool can help study things down to a cellular level and reveal the processes responsible for the formation of plaque buildup.
Atherosclerosis, the medical term for arterial hardening, affects nearly half of American adults between the ages of 45 and 84, per the National Institutes of health (NIH). Many people with it have no idea. As time passes and plaque continues to accumulate, this can impede blood flow. When a piece breaks off in a place that can fully block blood flow, it can lead to fatal strokes and heart attacks.
Doctors and researchers have been racing to better understand the nuances to plaque formation and stability in order to better treat patients. Now, with the “atlas of atherosclerosis,” this might just be possible.
“To begin to develop effective treatments targeting specific disease processes in the vessel wall, we need to characterize gene expression programs at single-cell resolution,” says researcher Clint L. Miller, PhD, of the University of Virginia School of Medicine’s Center for Public Health Genomics, as well as its Departments of Biochemistry and Molecular Genetics and Public Health Sciences, in a media release. “By establishing this map, we can inform strategies to reprogram dysregulated cell states in order to prevent or reverse the disease or identify biomarkers to assess a patient’s risk of having clinical events.”
Miller and his team have successfully built a “comprehensive single cell map of human atherosclerosis” involving nearly 120,000 cells from atherosclerotic coronary and carotid arteries. The tool even made it possible to dissect rarer cell types within the plaques themselves. This research has also highlighted the evolution of smooth muscle cells as the disease progresses, which is important because some of these cells contribute to hardening or “calcification,” of the arteries.
“Beyond characterizing cell diversity, integrating this newly built atherosclerosis single-cell reference with large-scale human genetic data was critical to start identifying disease-causing cell types and subtypes,” says graduate student Jose Verdezoto Mosquera. “For example, we identified the contribution of smooth muscle cell subtypes, such as fibroblast-like and lipid-rich smooth muscle cells, as well as the genes associated with these phenotypes.”
The university researchers express that their new plaque map is a leap in the right direction, helping to develop more thorough interventions for patients with atherosclerosis and coronary artery disease. Not only this, but the technology can help recognize certain biomarkers to aid in heart attack and stroke prevention.
“We plan to extend this single-cell atlas with future iterations to include additional datasets from defined disease stages and patients from diverse backgrounds,” Miller says. “By integrating the corpus of single-cell data generated in the scientific community, we can mitigate sampling bias and establish more robust candidate disease mechanisms and potential interventions.”
Artery Atlas: The Dietitian’s Take
It’s no secret that the foods we eat can influence our risk of arterial plaque buildup and ultimately heart attacks, heart disease, and stroke. Diet is one of the largest influencers on cardiovascular health. Eating fatty meats and cheeses can increase LDL-cholesterol levels, while eating lots of white breads and desserts can increase triglyceride levels.
Still, take it from a registered dietitian: making plaque completely go away isn’t possible, although making dietary changes to prevent more from forming is. Also, diet isn’t the only player here. Exercise, stress, smoking, and sleep all play a role as well.
This atlas has lots of potential for deepening the medical understanding of heart disease because of how much information it can tell you. I like that this tool can explore things like immune and smooth muscle cells, because these have a strong effect on plaque development and progression.
You may have heard that cholesterol is what leads to blocked arteries, but that’s not entirely true, and the thousands of cells involved in this research shows that. Plaque is a mix of different things, such as cholesterol, fat, waste from cells, calcium, and more. This is why a tool that can assess these nuances fully is important for improving quality of care and patient outcomes.
Moreover, it’s critical to know that harmful plaque buildup takes years to develop, and using a tool like this to assess changes over long periods of time can help healthcare professionals better understand how to care for patients both early on and later.
The findings are published in the journal Cell Reports.
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