Abstract
There is a universal lack of exposure response between degree of lipid lowering and
the outcome in clinical and angiographic trials questioning the current view on atherogenesis.
However, there are numerous observations and experiments suggesting that microorganisms
may play a causal role. A clue is the fact that the lipoproteins constitute an innate
immune system by binding and inactivating microorganisms and their toxic products
through formation of circulating complexes. Their size may increase in the presence
of hyperhomocysteinemia because homocysteine reacts with low-density lipoprotein (LDL)
to form homocysteinylated LDL aggregates. Autoantibodies against homocysteinylated
or oxidized LDL may also enhance the aggregation. Because of the high extracapillary
pressure, such aggregates may obstruct arterial vasa vasorum producing ischemia and
cell death within the arterial wall leading to the creation of a vulnerable plaque.
The many epidemiological observations, clinical findings and laboratory experiments
that conflict with the cholesterol hypothesis are in good accordance with ours.
Key Indexing Terms
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Article info
Publication history
Accepted:
January 13,
2012
Received:
October 19,
2011
Footnotes
K.S. McCully holds U.S. patents on synthetic homocysteine thiolactone derivatives for use in therapy of degenerative diseases of aging.
Identification
Copyright
© 2012 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
