DOI: 10.1002/cns.70992 ISSN: 1755-5930

Inflammatory Neovascularization and Vascular Remodeling Associated With Carotid Plaque Destabilization

Xuejiao Dai, Jia Huang, Feihua Ni, Ruying Hu, Huiyan Zheng, Dan Wang, Jianqiao Zhang, Ting Sun

ABSTRACT

Aims

Inflammatory responses promote pathological neovascularization and vascular remodeling in carotid plaques, contributing to plaque destabilization. This study aims to clarify specific cellular subpopulations that mediate pathological neovascularization and vascular remodeling in different plaque regions.

Methods

This study systematically analyzed the cellular composition and functional distribution in the atherosclerotic core (AC) and proximal adjacent (PA) regions of carotid plaques using single‐cell RNA sequencing.

Results

We observed that a subset of endothelial cells contributing to pathological neovascularization was prominent in the AC region, while the PA region exhibited a reduction in contractile vascular smooth muscle cells (VSMCs) and an increase in osteogenic VSMCs, collectively contributing to vascular remodeling. Additionally, fibroblast‐mediated inflammatory regulation was predominantly enriched in the PA region, whereas the AC region harbored more macrophage subsets involved in lipid metabolism and immune responses.

Conclusion

The pathological neovascularization mediated by endothelial cell subpopulations in the AC region, along with the reduced contractile VSMCs and increased osteogenic VSMCs in the PA region, is a factor that promotes plaque instability.

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