In a new study from Massachusetts General Hospital, researchers found high cholesterol and inflammation are key drivers of heart disease, and an inflamed buildup of lipids can cut off the blood supply through a coronary artery to cause a heart attack.
White blood cells, which usually defend against infection, trigger inflammation in these situations.
In patients with heart disease, white blood cells are more numerous.
Many of these cells can be found in a plaque—the buildup of fats, cholesterol, and other substances in a blood vessel—where they arrive after being born in the bone marrow and migrating through the blood stream.
But what leads to their increased bone marrow output is not clear.
In the study, the team examined human bone marrow and mice, and then found that high blood pressure, atherosclerosis, and the occurrence of a heart attack each can cause changes in the number of blood vessels in the bone marrow.
These hallmarks of heartbdisease also changed the bone marrow vessels’ structure and function and affected their release of factors that regulate white blood cell production and migration.
As a consequence, more white blood cells were available in the body, and this increase, called leukocytosis, propels inflammation everywhere, including in the arteries and the heart.
This fining allows the team to now examine how to reduce white blood cell production to normal values, thereby cooling off inflamed plaques anywhere in the body.
This study provides strong evidence that heart disease affects the bone marrow vasculature and consequently blood stem cell activity.
This work sheds new light on the important role played by the vascular bone marrow niche and how inflammation occurs.
It could lead to new targets and treatments for heart disease, the leading cause of death.
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The study is published in Nature Cardiovascular Research. One author of the study is Matthias Nahrendorf, MD, Ph.D.
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