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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“Rules and particular inferences alike are justified by being brought into agreement with each other. A rule is amended if it yields an inference we are unwilling to accept; an inference is rejected if it violates a rule we are unwilling to amend. The process of justification is the delicate one of making mutual adjustments between rules and accepted inferences; and in the agreement achieved lies the only justification needed for either.”
—Nelson Goodman (b. 1906)