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    How do Ldls get under the endothelium of blood vessels and how does it cause damage?

    (Original post by Jennifer50)
    How do Ldls get under the endothelium of blood vessels and how does it cause damage?
    LDLs can actually invade the endothelium when there is damage to the endothelium (endothelial dysfunction). This can be caused by a range of things such as hyperglycaemia (which is why diabetes mellitus is a huge risk factor) which forms advanced glycation end products which damages the endothelium, hyperlipidaemia, hypertension. These LDLs carry cholesterol and trigylcerides and can get deposited under the endothelium in the walls of arteries. Over time (and if there is insufficient HDL levels to carry cholesterol back to the liver) these fatty deposits begin to accumulate to form an atheroma and these LDLs can get oxidised which triggers an inflammatory response causing macrophages and other immune cells to accumulate in the area. Macrophages actually ingest these LDLs and become foam cells. Eventually these foam cells rupture, releasing cytokines, triglycerides and cholesterol into the arterial wall, causing the atheroma to get larger and reduce the diameter of the lumen of the artery, reducing blood flow. These cytokines cause smooth muscle cells from the tunica media to migrate to the tunica intima where they begin to release collagen which forms a fibrous capsule around the atheroma. Over time, the fibrous capsule gets larger and may calcify which reduces the elasticity of the artery wall - which further reduces blood flow. This fibrous capsule can rupture forming a thromboembolus which may travel in the blood where it can block smaller vessels. If this occurs in the coronary arteries it can cause a myocardial infarction (heart attack).

    I thought you misspelled Lidl's in the title... lel


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