Document Detail


Is atherosclerosis a neurogenic phenomenon?
MedLine Citation:
PMID:  17400398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Identified risk factors for atherosclerosis include diet, age, gender, family history, stress, lifestyle, smoking, diabetes, dyslipidemias, hypertension, and HIV. The mechanistic rationale to explain these associations remains poorly understood. We believe that these seemingly unrelated entities may promote atherosclerosis through a common pathway by inducing adventitial autonomic dysfunction, specifically as an adventitial stress dysfunction of neurogenic origin. Atherosclerosis may represent a local vascular manifestation of the global autonomic dysfunction induced by age, smoking, hypertension, HIV, and diabetes. Atherosclerosis may also participate in a feed-forward cycle as aging, diabetes, dyslipidemia, and hypertension may also represent independent downstream consequences of global sympathetic bias. Chronic physiologic stress and behavioral stress can shift the autonomic balance towards a state of sympathetic predominance. The highly communicable nature of behavioral stress may partially implicate the familial association of atherosclerosis as an epigenetic phenomenon, independent of putative genetic mechanisms. Host stress, global autonomic dysfunction, and sympathetic bias may also arise from chronic maladaptive consumption of stressed foods, as organisms detect and assimilate the stress phenotypes of their dietary constituents through a process called xenohormesis. The benefits of exercise may operate through reduction of chronic physiologic stress associated with global sympathetic bias. The neurogenic adventitial stress response may explain the local tissue remodeling seen in atherosclerosis, including adventitial adipose dysfunction, inflammation, adventitial angiogenesis, thrombosis, and endothelial dysfunction. We believe that the locations of atherosclerotic lesions correspond to regions of neurogenic adventitial autonomic dysfunction, in similar fashion to the segmental patterns of involvement found in inflammatory bowel disease. The diffuse atherosclerosis exhibited in transplanted hearts may reflect a diffuse sympathetic bias of the donor heart, since tissues and organs exhibit an intrinsic sympathetic bias in the absence of an extrinsic source of autonomic hegemony. Once we regard atherosclerosis as a neurogenic phenomenon manifested in adventitial autonomic dysfunction, novel diagnostic and therapeutic paradigms become evident.
Authors:
Rakesh S Marwah; John D Doux; Patrick Y Lee; Anthony J Yun
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Publication Detail:
Type:  Journal Article     Date:  2007-04-02
Journal Detail:
Title:  Medical hypotheses     Volume:  69     ISSN:  0306-9877     ISO Abbreviation:  Med. Hypotheses     Publication Date:  2007  
Date Detail:
Created Date:  2007-08-20     Completed Date:  2007-10-24     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  7505668     Medline TA:  Med Hypotheses     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  884-7     Citation Subset:  IM    
Affiliation:
Palo Alto Institute, 470 University Avenue, Palo Alto, CA 94301, USA.
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MeSH Terms
Descriptor/Qualifier:
Atherosclerosis / diagnosis,  etiology,  physiopathology*,  therapy
Humans
Models, Neurological
Nervous System Diseases / physiopathology*
Nervous System Physiological Phenomena*
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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