Atherosclerosis in women: immune regulation under sex differences

Abstract

Atherosclerosis (AS) is a chronic inflammatory disease initiated by abnormal subendothelial lipid deposition in blood arteries. Although endothelial dysfunction, lipid homeostasis imbalance, and clonal proliferation of vascular smooth muscle cells are central to classical theories, recent studies have shown that immune cells such as neutrophils, T lymphocytes, and macrophages dynamically infiltrate the plaque microenvironment. This evidence suggests that the immune regulatory network plays a significant role in the pathological process of AS. It should be noted that female patients exhibit distinct clinical phenotypes and pathological characteristics during AS. This sex difference is closely related to changes in sex hormone levels, such as estrogen, as well as to differences in inflammatory responses and metabolic regulation. Studies aiming to control the progression of AS by targeting immune mechanisms unique to women remain in the exploratory stage, and their potential mechanisms of action and regulation have not yet been well clarified. This study will systematically elucidate immune activity and provide a theoretical basis for effective intervention strategies for cardiovascular disease in women, focusing on immunological remodeling and the relationship between sex and immunity in AS.

Keywords

Atherosclerosis / female / immune cells / estrogen

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