AUTHOR=Zuo Xiao , Ding Xueqin , Zhang Yaya , Kang Y. James 

TITLE=Reversal of atherosclerosis by restoration of vascular copper homeostasis

JOURNAL=Experimental Biology and Medicine

VOLUME=Volume 249 - 2024

YEAR=2024

URL=https://www.ebm-journal.org/journals/experimental-biology-and-medicine/articles/10.3389/ebm.2024.10185

DOI=10.3389/ebm.2024.10185

ISSN=1535-3699

ABSTRACT=Atherosclerosis has traditionally been considered as a disorder characterized by the accumulation of cholesterol and thrombotic materials within the arterial wall. However, it is now understood to be a complex inflammatory disease involving multiple factors. Central to the pathogenesis of atherosclerosis are the interactions among monocytes, macrophages, and neutrophils, which play pivotal roles in the initiation, progression, and destabilization of atherosclerotic lesions. Recent advances in our understanding of atherosclerosis pathogenesis, coupled with results obtained from experimental interventions, lead us to propose the hypothesis that atherosclerosis may be reversible. This paper outlines the evolution of this hypothesis and presents corroborating evidence that supports the potential for atherosclerosis regression through the restoration of vascular copper homeostasis. We posit that these insights may pave the way for innovative therapeutic approaches aimed at the reversal of atherosclerosis.Recently advanced understanding of pathogenesis of atherosclerosis transformed the disease treatment approach from slowing its progression to promoting the regression of atherosclerosis.Copper plays a critical role in the regulation of structural integrity and lipid metabolism of vascular tissue. However, copper is deficient in the atherosclerotic vasculature, and contrarily elevated in the blood of atherosclerotic patients. Experimental restoration of copper homeostasis between the vessel wall and the circulation reverses the established atherosclerosis in animal models. It is predictable that the time is coming for therapeutic reversal of atherosclerosis.