The activation of the bone marrow could play a fundamental role in the origin and development of atherosclerosis, the process by which a progressive deposit of fat is produced in the walls of the arteries, underlying that of many cardiovascular diseases such as heart attack or stroke.
A study carried out by a team of researchers from the National Center for Cardiovascular Research (CNIC), led by cardiologists Valentín Fuster and Borja Ibáñez, suggests that the bone marrow is activated in response to cardiovascular risk factors. This activation produces an increase in inflammatory cells in the blood, which trigger a process that would lead to the onset and subsequent progression of atherosclerotic disease, according to a note from the CNIC released this Tuesday, after the publication of the results in the journal European HeartJournal.
Atherosclerosis is a process by which there is a progressive deposition of fat and inflammatory material in the walls of the arteries, the so-called “atheromal plaques”, and after many years of silent course, these plaques can cause thrombosis, causing an acute myocardial infarction, cerebral stroke or even sudden death.
Most common cause of death worldwide
Atherosclerosis is considered the “silent killer”, since it is the most frequent cause of death worldwide, and it has a long course before showing its face.
For this reason, identifying atherosclerotic disease in its early stages, even before it causes symptoms, is one of the main objectives of the PESA-CNIC-Santander (Progression of Early Subclinical Atherosclerosis) study led by Valentín Fuster, general director of the CNIC and director physician at Mount Sinai Hospital in New York.
This work lays the foundations to fight this disease, attacking the roots of its development, the CNIC has underlined. Borja Ibáñez, director of the Department of Clinical Research at the CNIC and cardiologist at the Fundación Jiménez Díaz University Hospital, stressed that “early identification of atherosclerosis will allow us to advance in understanding the mechanisms by which it occurs, which opens the door to door to find new treatments that can prevent the progression of this deadly disease.
The researcher stressed that atherosclerosis has been known for many decades, but also that the ultimate mechanisms responsible for the onset of the disease are not fully understood.
Risk factor’s
CNIC cardiologist Ana Devesa, first author of the article, explained that the risk factors that cause bone marrow activation are those that are related to metabolic syndrome: central obesity (increased waist circumference), triglycerides high blood pressure, low HDL cholesterol, high blood glucose, insulin resistance, and high blood pressure.
These factors cause an increase in metabolic activity in the bone marrow that can be observed using advanced imaging techniques, such as positron emission tomography (PET) and magnetic resonance imaging (MRI) hybrid technology, a technology available at the CNIC .
“The increase in activity in the bone marrow triggers an inflammatory process that activates the atherosclerosis process, from its most incipient phases to the appearance of established plaque”, explained Dr. Devesa.
The work has been carried out within the PESA CNIC-Santander study, a joint project between the CNIC and Banco Santander that began more than 10 years ago and has the participation of 4,200 middle-aged bank workers (40-55 years when they were included in the study), apparently healthy, who are followed up periodically using state-of-the-art imaging technology, as well as through blood samples.
The study has recently been extended and will last until at least 2029, so the follow-up will be up to almost 20 years in all the participants, something that according to its promoters is “unique” in the world.
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