Efferocytosis of vascular cells in cardiovascular disease

Cell death and the clearance of apoptotic cells are tightly regulated by various signaling molecules in order to maintain physiological tissue function and homeostasis. The phagocytic removal of apoptotic cells is known as the process of efferocytosis, and abnormal efferocytosis is linked to various health complications and diseases, such as cardiovascular disease, inflammatory diseases, and autoimmune diseases. During efferocytosis, phagocytic cells and/or apoptotic cells release signals, such as find me and eat me signals, to stimulate the phagocytic engulfment of apoptotic cells. Primary phagocytic cells are macrophages and dendritic cells; however, more recently, other neighboring cell types have also been shown to exhibit phagocytic character, including endothelial cells and fibroblasts, although they are comparatively slower in clearing dead cells. In this review, we focus on macrophage efferocytosis of vascular cells, such as endothelial cells, smooth muscle cells, fibroblasts, and pericytes, and its relation to the progression and development of cardiovascular disease. We also highlight the role of efferocytosis-related molecules and their contribution to the maintenance of vascular homeostasis. (C) 2021 Elsevier Inc. All rights reserved.

Automated summary

Cell death and the clearance of apoptotic cells are regulated by signaling molecules. Abnormal clearance of apoptotic cells is associated with various health complications and diseases. During this process, phagocytic cells and/or apoptotic cells release signals to promote engulfment of apoptotic cells. In addition to macrophages and dendritic cells, other cell types such as endothelial cells and fibroblasts can also engulf apoptotic cells, although at a slower rate. This review focuses on the macrophage efferocytosis of vascular cells and its relation to cardiovascular disease, emphasizing the importance of efferocytosis-related molecules in maintaining vascular homeostasis.