Obesity, smoking, poor diet, high blood pressure and diabetes. While we all know the major risk factors for heart disease, less well-known is the fact that clogged arteries are not simply a "plumbing" problem. Research now shows that arterial disease results to a large extent, from the body's own protective immune reactions run amok.

Inflammation is, of course, the body's natural response to a wound or infection. Redness and swelling occur as extra blood brings circulating immune cells to do battle with any invading organisms. Chemical signals then damp down that immune response once an infection is cleared or the wound heals.

This normal immune rebalancing, however, is somehow derailed in the millions of North Americans who die of complications of atherosclerosis, the process by which fatty deposits build up in the inner lining of an artery and form yellowish plaques.

"Blood vessels have got to be the world's perfect healers as they are getting continuously bombarded by blood pressure," explains clinician-scientist Dr. Geoffrey Pickering, a cardiologist whose research as co-director of the Vascular Biology Group at Robarts Research Institute explores the genetic and cellular mechanisms involved in the fibrous cap that forms over arterial plaque and keeps it stable. "If we can understand the genetic factors and cellular mechanisms behind how these deposits grow, and why some become unstable but others don't, we may be able to improve the odds for millions of people at risk of heart attack and stroke."

Since Robarts' inception, atherosclerosis and stroke have been key areas of research at the Institute. From the clinic to the cellular level, the Robarts approach involves novel collaborations among scientists across a range of disciplines.

Scientist Dr. David Spence, for example, director for the last 25 years of Canada's first Stroke Prevention Clinic and Atherosclerosis Research Centre in London, Ont., estimates he has seen more than 16,000 patients, many of whom have been involved in innovative projects with imaging and genomics experts that aim to better manage risk factors for stroke and discover new therapeutic targets.

By Linda Quattrin

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