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2021 Jeffrey M. Hoeg Award Lecture: Defining the Role of Efferocytosis in Cardiovascular Disease: A Focus on the CD47 (Cluster of Differentiation 47) Axis

Journal

ARTERIOSCLEROSIS THROMBOSIS AND VASCULAR BIOLOGY
Volume 42, Issue 6, Pages E145-E154

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/ATVBAHA.122.317049

Keywords

atherosclerosis; cardiovascular diseases; efferocytosis; inflammation; risk factors

Funding

  1. Deutsche Forschungsgemeinschaft [JA 2869/11:1]
  2. Deutsche Herzstiftung e.V. [S/09/19]
  3. National Institutes of Health [R35 HL144475]
  4. American Heart Association [EIA34770065]

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The article summarizes how inflammation-dependent changes lead to atherogenesis and promote lesion expansion and plaque vulnerability, and presents reversible intervention methods. Emphasis is placed on the importance of the CD47 "do not eat me" axis, which has emerged as a novel anti-atherosclerotic translational target.
A key feature of atherogenesis is the accumulation of diseased and dying cells within the lesional necrotic core. While the burden of intraplaque apoptotic cells may be driven in part by an increase in programmed cell death, mounting evidence suggests that their presence may primarily be dictated by a defect in programmed cell removal, or efferocytosis. In this brief review, we will summarize the evidence suggesting that inflammation-dependent changes within the plaque render target cells inedible and reduce the appetite of lesional phagocytes. We will present the genetic causation studies, which indicate these phenomena promote lesion expansion and plaque vulnerability, and the interventional data which suggest that these processes can be reversed. Particular emphasis is provided related to the antiphagocytic CD47 (cluster of differentiation 47) do not eat me axis, which has emerged as a novel antiatherosclerotic translational target that is predicted to provide benefit independent of traditional cardiovascular risk factors.

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