Cell composition of the subendothelial aortic intima and the role of alpha-smooth muscle actin expressing pericyte-like cells and smooth muscle cells in the development of atherosclerosis

The cell composition of the human arterial intima has been intensely studied but is still not well understood. The majority of cell population in normal and atherosclerotic intima is represented by cells expressing smooth muscle α-actin, which are thought to be smooth muscle cells. Some antigens, which are absent in medial smooth muscle cells, were detected in intimal smooth muscle cells. In particular, using 3G5 antipericyte antibody, presence of stellate-shaped pericyte-like resident cells in normal and atherosclerotic human aortic intima has been found. In all analyzed aortic tissue specimens, 3G5+ cells were found to account for more than 30% of the total intimal cell population of undiseased intima. In the atherosclerotic lesions, the number of 3G5+ cells becomes notably lower than that in undiseased intima. The use of 2A7 antibody that identifies activated pericytes revealed the presence of 2A7+ cells in atherosclerotic plaques, while no 2A7+ cells were detected in normal intima. The strongest correlation was established between the number of pericyte-like cells and the content of intimal lipids. The correlation coefficients between the number of pericyte-like cells and collagen content and intimal thickness were greater than the correlation coefficients for smooth muscle cells. On the basis of these findings, pericyte-like cells but not smooth muscle cells or other cell types have been declared to be the key cellular element driving the formation of atherosclerotic lesions. The present chapter aims to detail the abovementioned issues. The present chapter also aims to promote a view that α-smooth muscle actin+ pericyte-like cells represent the key players in the development of atherosclerotic lesions.