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Mechanism of efferocytosis in atherosclerosis

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Abstract

Atherosclerosis (AS) is a chronic inflammatory vascular disease that occurs in the intima of large and medium-sized arteries with the immune system’s involvement. It is a common pathological basis for high morbidity and mortality of cardiovascular diseases. Abnormal proliferation of apoptotic cells and necrotic cells leads to AS plaque expansion, necrotic core formation, and rupture. In the early stage of AS, macrophages exert an efferocytosis effect to engulf and degrade apoptotic, dead, damaged, or senescent cells by efferocytosis, thus enabling the regulation of the organism. In the early stage of AS, macrophages rely on this effect to slow down the process of AS. However, in the advanced stage of AS, the efferocytosis of macrophages within the plaque is impaired, which leads to the inability of macrophages to promptly remove the apoptotic cells (ACs) from the organism promptly, causing exacerbation of AS. Moreover, upregulation of CD47 expression in AS plaques also protects ACs from phagocytosis by macrophages, resulting in a large amount of residual ACs in the plaque, further expanding the necrotic core. In this review, we discussed the molecular mechanisms involved in the process of efferocytosis and how efferocytosis is impaired and regulated during AS, hoping to provide new insights for treating AS.

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Funding

This work was supported by the Scientific Research Project of Hunan Provincial Department of Education (23A0338) and the Project of the Hunan Provincial Health Committee (D202302048902) and the College Student Innovation and Entrepreneurship Training Program of Hunan Province (S202210555279, S202310555323, S202310555104, and S202310555321), University of South China, China.

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  1. Li-Xia Shu, Liu-li Cao and Xin Guo contributed equally to this work.

Authors and Affiliations

  1. Institute of Pharmacy and Pharmacology, School of Pharmaceutical Sciences, Hengyang Medical School, University of South China, Hengyang, 421001, China

    Li-Xia Shu, Liu-li Cao, Xin Guo, Zong-Bao Wang & Shu-Zhi Wang

  2. Hunan Province Cooperative Innovation Center for Molecular Target New Drug Study, University of South China, Hengyang, 421001, China

    Li-Xia Shu, Liu-li Cao, Xin Guo, Zong-Bao Wang & Shu-Zhi Wang

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Li-Xia Shu designed the review, prepared the figures, and wrote the review. Xin Guo prepared the table, consulted the literature, and co-wrote the review. Liu-li Cao revised the review. Zong-Bao Wang and Shu-Zhi Wang supervised the project, provided scientific direction, and revised the review.

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Shu, LX., Cao, Ll., Guo, X. et al. Mechanism of efferocytosis in atherosclerosis. J Mol Med (2024). https://doi.org/10.1007/s00109-024-02439-3

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