New challenges in the etiopathogenesis of atherothrombosis.

Atherosclerotic disease is a focal pathological event characterized by thickening and hardening of large arteries due to the accumulation of lipids, proteoglycans, blood and blood products, fibrous tissue and calcium deposits. The formation of arterial thrombi appears to be a significant factor for the occurrence of clinical acute complications in asymptomatic chronic atherosclerosis. The knowledge obtained on the mechanisms of platelet activation, signal transduction, receptor binding, zymogen activation and function, substrate recognition and adhesive events has been useful to design new intervention techniques with beneficial results and new highly promising strategies. It was initially thought that receptors were only involved in binding functions, but they have also been shown to be important factors in the transduction of information from the extracellular compartment to the inside of the cell, and that they partly control cell function, structure, proliferation and differentiation. The availability of monoclonal antibodies and the molecular biology techniques applied to the fields of thrombosis, and the interaction between blood cells and the vascular wall will provide tools to explore specific pathways of cell activation and interaction between cells. These studies, together with those aimed at finding the main agonists and substrates triggering and perpetuating an event, will be helpful to establish strategies for treatment and prevention of clinical events and to reduce the associated morbidity and mortality. Copyright 2001 S. Karger AG, Basel