The Inflammatory Process
The first phase of the inflammatory process is marked by the accumulation of lipid and low-density lipoprotein (LDL) particles beneath the endothelium. This is followed by the attachment of leukocytes, monocytes, and T-lymphocytes to the endothelial cell surface. Leukocytes migrate to the subendothelial space and aggregate within the intima.
In the presence of elevated levels of oxidized LDL (ox-LDL), monocytes are converted to activated macrophages. Macrophages accumulate modified lipid particles and become foam cells. The formation of foam cells and their continued accumulation in the intima lead to the formation of fatty streaks. Continued cell migration and proliferation eventually result in the formation of a fibrous plaque.
Read more about this topic: Chronic Endothelial Injury Hypothesis
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“At last a vision has been vouchsafed to us of our life as a whole. We see the bad with the good.... With this vision we approach new affairs. Our duty is to cleanse, to reconsider, to restore, to correct the evil without impairing the good, to purify and humanize every process of our common life, without weakening or sentimentalizing it.”
—Woodrow Wilson (1856–1924)