These are what are sought with the carotid Doppler ultrasound: atherosclerotic plaques. Formed by an accumulation of fats, cholesterol, fibrous tissue and cells of the immune system, they represent the hallmark of atherosclerosis, the consequences of which – from heart attack to stroke to peripheral vascular problems – are in fact the main cause of death in old age. A new research, which sees among the main protagonists the Department of Angiocardioneurology and Translational Medicine of the Irccs Neuromed in Pozzilli (Is), demonstrates for the first time the existence of a connection between atherosclerotic plaques and the central nervous system, which in turn, through the spleen, it activates the immune system, further stimulating the development of the disease. This hitherto unknown ‘nervous circuit’ could represent a target for innovative therapies.
Published in the journal ‘Nature’, the study was conducted both on experimental models and in human finds, in collaboration with the Ludwig-Maximilians-University of Munich and with other international scientific institutions united in the European Community-funded “Plaquefight” project. “In correspondence with an atherosclerotic plaque – explains Daniela Carnevale, department of Angiocardioneurology and translational medicine at Neuromed and full professor at the Sapienza University of Rome – an aggregate of immune cells is also formed in the external wall of the blood vessel. This lymph node-like aggregate, called ‘Atlo’, is rich in nerve fibers. Our work has first of all shown that through them a direct connection is established between the plaque and the brain ”.
The Italian and German researchers then reconstructed the entire path of the nerve fibers up to the central nervous system. “At this point – continues Carnival – we were able to see that these signals coming from the plaque, once they reach the brain, influence the autonomic nervous system through the vagus nerve (the nerve that controls most of our organs and visceral functions , ed) until it reaches the spleen. Here there is an activation of specific cells of the immune system that enter the circulation and lead to the progression of the plaques themselves “.
It is a real nervous circuit, which the authors of the research have defined ‘Abc’ or ‘artery-brain circuit’. And like all circuits, it can be disconnected or modulated. “We have conducted – adds Daniela Carnevali – further experiments by interrupting the nerve connections that reach the spleen. In this way, the impulses on the immune cells present in this organ have failed. The result is that the plaques in the arteries not only slowed growth, but stabilized. “
Considering that the stability of atherosclerotic plaque is one of the most clinically relevant traits in assessing the severity of the disease in the patient, and that in this study the components of the ‘Abc’ circuit were also identified in findings of human arteries affected by atherosclerosis, it is expected a very significant translational potential. “It is an absolutely new vision – comments Giuseppe Lembo, head of the department of Angiocardioneurology and translational medicine Neuromed and Ordinary at Sapienza in Rome – which opens the way to therapeutic strategies hitherto unknown. The hypothesis to work on now is the possibility of acting, with specific bioelectronic devices, on the nerve endings that reach the spleen, in particular on the branch of the vagus nerve which is connected to the celiac ganglion. In other words, a non-pharmacological therapeutic intervention to counter the problem of atherosclerosis “.
“Years and years of hard work are concentrated in this research – concludes Lembo -. The commitment and originality of our researchers, capable of bringing together multidisciplinary interests that involve the brain, the cardiovascular system and the immune system, project us today on the international scene as a leading point of reference “.
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