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Peer-reviewedCC BYMedComm

Atherosclerosis: From Pathogenesis to Therapeutic Interventions

  • Enge Zhou1
  • Chenxi Zhan2
  • Yuting Li1
  • Yi Zeng1
  • Renfei Luo1,3
  • Xin Ouyang1
  • Shixing Liu1
  • Renqiang Yang1
  • Nianlong Yan1,2
  • Long Jiang1
  1. 1Department of Cardiovascular Medicine, The Second Affiliated Hospital, Jiangxi Medical College Nanchang University Nanchang Jiangxi China.
  2. 2Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Jiangxi Medical College Nanchang University Nanchang Jiangxi China.
  3. 3Affiliated Rehabilitation Hospital of Nanchang University Nanchang Jiangxi China.
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Abstract

Atherosclerosis is no longer viewed solely as a lipid-storage disorder but rather as a complex multisystem inflammatory disease driven by interactions among the vascular, immune, metabolic, and nervous systems. This review integrates recent concepts, including trained immunity, the neuroimmune cardiovascular interface, vascular cell plasticity, and the microbiome-vascular axis, that reshape the understanding of plaque initiation, progression, and instability. We summarize how established lipid-lowering, antidiabetic, antihypertensive, and revascularization strategies influence atherosclerotic disease and discuss emerging interventions, including RNA therapeutics, anti-inflammatory agents, gene therapy, and cell-based approaches. Key ongoing clinical trials that may clarify the cardiovascular benefits and safety of these strategies are also reviewed. Despite therapeutic advances, residual cardiovascular risk persists because of limitations in animal models, sex-related differences in plaque phenotype, and the lack of clinically applicable biomarkers. Nanotechnology, human microphysiological systems, spatial multiomics, and artificial intelligence may help bridge these translational gaps. Successful clinical implementation will nevertheless require biomarker-guided patient selection, rational combination therapy, validated surrogate endpoints, long-term safety assessment, and attention to health economics. In summary, these advances will shape future translational research and clinical trial design, ultimately advancing personalized management of atherosclerosis.

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Cite

BibTeXRIS
BibTeX
@article{zhou2026atherosclerosis,
  title = {{Atherosclerosis: From Pathogenesis to Therapeutic Interventions}},
  author = {Enge Zhou and Chenxi Zhan and Yuting Li and Yi Zeng and Renfei Luo and Xin Ouyang and Shixing Liu and Renqiang Yang and Nianlong Yan and Long Jiang},
  journal = {MedComm},
  year = {2026},
  month = oct,
  doi = {10.1002/mco2.71095},
  url = {https://europepmc.org/article/PMC/PMC13717303},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Atherosclerosis: From Pathogenesis to Therapeutic Interventions
AU  - Enge Zhou
AU  - Chenxi Zhan
AU  - Yuting Li
AU  - Yi Zeng
AU  - Renfei Luo
AU  - Xin Ouyang
AU  - Shixing Liu
AU  - Renqiang Yang
AU  - Nianlong Yan
AU  - Long Jiang
PY  - 2026
DA  - 2026/10/29
JO  - MedComm
DO  - 10.1002/mco2.71095
UR  - https://europepmc.org/article/PMC/PMC13717303
AB  - Atherosclerosis is no longer viewed solely as a lipid-storage disorder but rather as a complex multisystem inflammatory disease driven by interactions among the vascular, immune, metabolic, and nervous systems. This review integrates recent concepts, including trained immunity, the neuroimmune cardiovascular interface, vascular cell plasticity, and the microbiome-vascular axis, that reshape the understanding of plaque initiation, progression, and instability. We summarize how established lipid-lowering, antidiabetic, antihypertensive, and revascularization strategies influence atherosclerotic disease and discuss emerging interventions, including RNA therapeutics, anti-inflammatory agents, gene therapy, and cell-based approaches. Key ongoing clinical trials that may clarify the cardiovascular benefits and safety of these strategies are also reviewed. Despite therapeutic advances, residual cardiovascular risk persists because of limitations in animal models, sex-related differences in plaque phenotype, and the lack of clinically applicable biomarkers. Nanotechnology, human microphysiological systems, spatial multiomics, and artificial intelligence may help bridge these translational gaps. Successful clinical implementation will nevertheless require biomarker-guided patient selection, rational combination therapy, validated surrogate endpoints, long-term safety assessment, and attention to health economics. In summary, these advances will shape future translational research and clinical trial design, ultimately advancing personalized management of atherosclerosis.
SN  - 2688-2663
ER  -