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Atherosclerosis: Viewing the problem from a different perspective including possible treatment options

dc.contributor.author Goldberg, JS
dc.date.accessioned 2015-08-19T22:09:12Z
dc.date.issued 2011-12-01
dc.identifier.uri https://hdl.handle.net/10161/10412
dc.description.abstract This paper proposes that atherosclerosis is initiated by a signaling event that deposits calcium hydroxyapatite (Ca-HAP). This event is preceded by a loss of mechanical structure in the arterial wall. After Ca-HAP has been deposited, it is unlikely that it will be reabsorbed because the solubility product constant (K sp) is very small, and the large stores of Ca +2 and PO 4-3 in the bones oppose any attempts to dissolve Ca-HAP by decreasing the common ions. The hydroxide ion (OH -) of Ca-HAP can be displaced in nature by fluoride (F -) and carbonate (CO 3-2) ions, and it is proposed that anions associated with cholesterol ester hydrolysis and, in very small quantities, the enolate of 7-ketocholesterol could also displace the OH -of Ca-HAP, forming an ionic bond. The free energy of hydration of Ca-HAP at 310 K is most likely negative, and the ionic radii of the anions associated with the hydrolysis of cholesterol ester are compatible with the substitution. Furthermore, examination of the pathology of atherosclerotic lesions by Raman and NMR spectroscopy and confocal microscopy supports deposition of Ca-HAP associated with cholesterol. Investigating the affinity of intermediates of cholesterol hydrolysis for Ca-HAP compared to lipoproteins such as HDL, LDL, and VLDL using isothermic titration calorimetry could add proof of this concept and may lead to the development of a new class of medications targeted at the deposition of cholesterol within Ca-HAP. Treatment of acute ischemic events as a consequence of atherosclerosis with denitrogenation and oxygenation is discussed. © the author(s), publisher and licensee Libertas Academica Ltd.
dc.publisher SAGE Publications
dc.relation.ispartof Lipid Insights
dc.relation.isversionof 10.4137/LPI.S7912
dc.title Atherosclerosis: Viewing the problem from a different perspective including possible treatment options
dc.type Journal article
duke.contributor.id Goldberg, JS|0011931
pubs.begin-page 17
pubs.end-page 26
pubs.organisational-group Anesthesiology
pubs.organisational-group Anesthesiology, VA Anesthesiology Service
pubs.organisational-group Clinical Science Departments
pubs.organisational-group Duke
pubs.organisational-group School of Medicine
pubs.publication-status Published
pubs.volume 4
dc.identifier.eissn 1178-6353


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