The role of adhesion molecules in atherosclerosis

The progression of atherosclerosis is currently believed to involve the int eraction of monocytes with the vascular endothelium. Within the last decade , the cell-surface proteins thought to control these interactions have been investigated. This review seeks to describe the nature of these interactio ns through what are known as adhesion molecules and their role in atherogen esis. It begins with the stages of atherogenesis from the movement of the m onocyte to the endothelium, followed by the migration of smooth muscle cell s from the media to the intima, and subsequently to the later stages of fib rofatty plaque formation and potential complications due to thrombosis and/ or plaque fissure and embolism. The different structural classifications of the adhesion molecules, such as integrins, cadherins, selectins, and membe rs of the immunoglobulin gene superfamily, are outlined, and interaction of binding domains are highlighted. The vascular endothelium and the basic ro le of adhesion molecules in dysfunction are considered. Discussion of the r ole of adhesion molcules in atherogenesis focuses on interactions of the en dothelium, monocytes, and leukocytes, as well as the influences of cytokine s, oxidized low-density lipoproteins, and genetic determinants. Finally, ep idemiological risk factors associated with atherosclerosis such as hyperten sion and dyslipidemia are considered in light of their effects on adhesion molecule expression.