The Immunological Biography of the Carotid Plaque: From Trained Immunity and Clonal Lymphocytes to Spatial Immune Niches and Plaque Vulnerability
7 affiliations
- 1Department of Vascular, Endovascular Surgery, Angiology and Phlebology, Poznan University of Medical Science, ½ Dluga Street, 61-848 Poznań, Poland
- 2Department of Precision Medicine in Medical Surgical and Critical Area (Me.Pre.C.C.), University of Palermo, 90134 Palermo, Italy
- 3Department of Research, IRCCS ISMETT, Via Ernesto Tricomi, 5, 90127 Palermo, Italy
- 4Department of Cardiac Surgery, Center of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior, 02-507 Warszawa, Poland
- 5Thoracic Research Center, Collegium Medicum, Nicolaus Copernicus University, 85-090 Bydgoszcz, Poland
- 6Department of Hypertensiology, Angiology, and Internal Medicine, Poznan University of Medical Sciences, ½ Dluga Street, 61-848 Poznań, Poland
- 7Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, ½ Długa Street, 61-848 Poznań, Poland
Abstract
Atherosclerotic carotid plaques are shaped by years of interaction between systemic risk factors, hematopoietic conditioning, vascular injury, and local immune responses, yet conventional assessment captures only a limited snapshot of this biological history. This review introduces the concept of the “immunological biography” of the carotid plaque and examines how trained innate immunity, macrophage state and defective resolution, adaptive immune memory, T- and B-cell clonal selection, and spatially organized immune niches contribute to plaque heterogeneity and vulnerability. The literature was identified through a structured PubMed search complemented by reference screening, with emphasis on human carotid tissue, paired blood–plaque studies, immune-repertoire analyses, and single-cell and spatial technologies. Current evidence indicates that immune-cell abundance alone incompletely characterizes plaque biology: functional state, antigen experience, clonality, tissue localization, and interactions with vascular and stromal cells provide additional levels of biological information. We propose the Carotid Plaque Immune Phenotype (CPIP) as an integrative framework linking systemic immune history with cellular state, clonal architecture, spatial organization, and clinically relevant plaque features. Combining circulating biomarkers with tissue-resolved immune profiling may ultimately improve biological phenotyping of carotid atherosclerosis and provide a framework for prospective studies linking plaque immune architecture with cerebrovascular events.
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BibTeX
@article{krasinski2026immunological,
title = {{The Immunological Biography of the Carotid Plaque: From Trained Immunity and Clonal Lymphocytes to Spatial Immune Niches and Plaque Vulnerability}},
author = {Zbigniew Krasiński and Giuseppe Maria Raffa and Mariusz Kowalewski and Beata Krasińska and Calogera Pisano and Stefano Cannata and Piotr Suwalski and Tomasz Urbanowicz},
journal = {Cells},
year = {2026},
month = oct,
doi = {10.3390/cells15211995},
url = {https://www.mdpi.com/2073-4409/15/21/1995},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - The Immunological Biography of the Carotid Plaque: From Trained Immunity and Clonal Lymphocytes to Spatial Immune Niches and Plaque Vulnerability
AU - Zbigniew Krasiński
AU - Giuseppe Maria Raffa
AU - Mariusz Kowalewski
AU - Beata Krasińska
AU - Calogera Pisano
AU - Stefano Cannata
AU - Piotr Suwalski
AU - Tomasz Urbanowicz
PY - 2026
DA - 2026/10/31
JO - Cells
DO - 10.3390/cells15211995
UR - https://www.mdpi.com/2073-4409/15/21/1995
AB - Atherosclerotic carotid plaques are shaped by years of interaction between systemic risk factors, hematopoietic conditioning, vascular injury, and local immune responses, yet conventional assessment captures only a limited snapshot of this biological history. This review introduces the concept of the “immunological biography” of the carotid plaque and examines how trained innate immunity, macrophage state and defective resolution, adaptive immune memory, T- and B-cell clonal selection, and spatially organized immune niches contribute to plaque heterogeneity and vulnerability. The literature was identified through a structured PubMed search complemented by reference screening, with emphasis on human carotid tissue, paired blood–plaque studies, immune-repertoire analyses, and single-cell and spatial technologies. Current evidence indicates that immune-cell abundance alone incompletely characterizes plaque biology: functional state, antigen experience, clonality, tissue localization, and interactions with vascular and stromal cells provide additional levels of biological information. We propose the Carotid Plaque Immune Phenotype (CPIP) as an integrative framework linking systemic immune history with cellular state, clonal architecture, spatial organization, and clinically relevant plaque features. Combining circulating biomarkers with tissue-resolved immune profiling may ultimately improve biological phenotyping of carotid atherosclerosis and provide a framework for prospective studies linking plaque immune architecture with cerebrovascular events.
SN - 2073-4409
ER -