The Artery and the Process of Arteriosclerosis: Pathogenesis The first half of the Proceedings of an Interdisciplinary Conference on Fundamental Data on Reactions of Vascular Tissue in Man April 19–25, 1970, Lindau, West Germany

321 Pages·1971·12.92 MB·English

by  Dr. John French (auth.)

The Artery and the Process of Arteriosclerosis
Pathogenesis
ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY
Editorial Board:
Nathan Back Chairman, Department of Biochemical Pharmacology, School of Pharmacy,
State University of New York, Buffalo, New York
N. R. Di Luzio Chairman, Department of Physiology,
Tulane University School of Medicine, New Orleans, Louisiana
Alfred Gellhorn University of Pennsylvania Medical School, Philadelphia, Pennsylvania
Bernard Halpern College de France,
Director of the Institute of Immuno-Biology, Paris, France
Ephraim Katchalski Department of Biophysics, The Weizmann Institute of Science, Rehovoth, Israel
David Kritchevsky Wistar Institute, Philadelphia, Pennsylvania
Abel Lajtha New York State Research Institute for Neurochemistry and Drug Addiction,
Ward's I~land, New York
Rodolfo Paoletti Institute 0/ Pharmacology, University 01 Milan, Milan, Italy
Volume 1 Volume 10
THE RETICULOENDOTHELIAL SYSTEM THE HUMAN TESTIS
AND ATHEROSCLEROSIS Edited by E. Rosemberg
Edited by N. R Di Luzio and C. A. Paulsen· 1970
and R Paoletti • 1967
Volume 2 Volume 11
PHARMACOLOGY OF HORMONAL MUSCLE METABOLISM DURING EXERCISE
POLYPEPTIDES AND PROTEINS Edited by B. Pernow and B. Saltin • 1971
Edited by N. Back, L. Martini,
and R Paoletti· 1968
Volume 12
Volume 3 MORPHOLOGICAL AND FUNCTIONAL
GERM-FREE BIOLOGY: Experimental ASPECTS OF IMMUNITY
and Clinical Aspects Edited by K. Lindahl-Kiessling, G. AIm, and
Edited by E. A_ Mirand and N_ Back· 1969 M. G. Hanna, Jr. • 1971 '
Volume 4
DRUGS AFFECTING LIPID METABOLISM
Volume 13
Edited by W_ L_ Holmes, L. A_ Carlson, CHEMISTRY AND BRAIN DEVELOPMENT
and R Paoletti • 1969 Edited by R Paoletti and A. N. Davison' 1971
Volume 5
LYMPHATIC TISSUE AND GERMINAL
Volume 14
CENTERS IN IMMUNE RESPONSE
MEMBRANE-BOUND ENZYMES
Edited by L_ Fiore-Donati
Edited by G. Porcellati and F. di Jeso • 1971
and M. G. Hanna, Jr. • 1969
Volume 6
Volume 15
RED CELL METABOLISM AND FUNCTION
THE RETICULOENDOTHELIAL SYSTEM
Edited by George J. Brewer· 1970
AND IMMUNE PHENOMENA
Volume 7 Edited by N. R. Di Luzio and K_ Flemming. 1971
SURFACE CHEMISTRY OF
BIOLOGICAL SYSTEMS Volume 16A
Edited by Martin Blank' 1970 THE ARTERY AND THE PROCESS
Volume 8 OF ARTERIOSCLEROSIS:
BRADYKININ AND RELATED KININS: Pathogenesis
Cardiovascular, Biochemical, and Neural Actions Edited by Stewart Wolf • 1971
Edited by F. Sicuteri, M. Rocha e Silva,
and N. Back • 1970 Volume 16B
Volume 9 THE ARTERY AND THE PROCESS
SHOCK: Biochemical, Pharmacological, OF ARTERIOSCLEROSIS:
and Clinical Aspects Measurement and Modification
Edited by A. Bertelli and N. Back· 1970 Edited by Stewart Wolf' 1971
The Artery and the
Process of Arteriosclerosis
Pathogenesis
The first half of the Proceedings of an Interdisciplinary Conference
on Fundamental Data on Reactions of Vascular Tissue in Man
April 19-25, 1970, Lindau, West Germany
Edited by
Stewart Wolf
University of Texas System Professor of Medicine
Professor of Medicine and of Physiology
The University of Texas Medical Branch and
Director, The Marine Biomedical Institute
Galveston, Texas
~
PLENUM PRESS • NEW YORK· LONDON • 1971
Steering Committee and Editorial Board:
John French, England Guenter Schlierf, Germany
C. J. Miras, Greece Marcel Vastesaeger, Belgium
Rodolfo Paoletti, Italy N. T. Werthessen, USA
Gotthard Schettler, Germany Stewart Wolf, USA
The second half of the proceedings will be published as
The Artery and Process of Arteriosclerosis: Measurement and Modification
(Volume 16B of this series).
Library of Congress Catalog Card Number 70·163284
ISBN 978-1-4684-8132-7 ISBN 978-1-4684-8130-3 (eBook)
DOl 10.1007/978-1-4684-8130-3
@ 1971 Plenum Press, New York
Softcover reprint of the hardcover 1st edition 1971
A Division of Plenum Publishing Corporation
227 West 17th Street, New York, N.Y. 10011
United Kingdom edition published by Plenum Press, London
A Division of Plenum Publishing Company, Ltd.
Davis House (4th Floor), 8 Scrubs Lane, Harlesden, NWlO 6SE, England
All rights reserved
DEDICATION
This volume is dedicated to the memory of Dr. John French,
distinguished pathologist and member of the Steering Committee
for the Lindau Conference. University Lecturer at the Sir William
Dunn School of Pathology and Fellow of St. Cross College, Oxford,
Dr. French's research contributed mightily to our knowledge of the
artery in health and disease. The clarity of his thinking, its
penetrating quality and his incisive comments greatly enriched the
Conference. Most of all his superior qualities as a man will be
missed by his many friends who attended this meeting.
v
PREFACE
The present volume contains the first half of the edited tran
script of a six-day Conference, "Fundamental Data on Reactions of
Vascular Tissue in Man," held April 19-25, 1970, in Lindau, West
Germany. The remainder of the proceedings, dealing with the epide
miologic, clinical and preventive aspects of arteriosclerosis, will
be published in a second volume.
The Conference was held under the auspices of the International
Society of Cardiology, the International Cardiology Foundation and
the European Atherosclerosis Group. The aim of the Conference was
to achieve a synthesis of present knowledge concerning arterioscle
rosis. Therefore, workers were brought together from several coun
tries and from various disciplines that do not ordinarily intercom
municate for free exchange of data and ideas. Six broad subject
areas were introduced by single papers; three of them are included
in this volume. In the discussion which followed each formal pres
entation, the participants attempted to reconcile disparate data and
interpretations and to reach .a clear identification of important areas
of ignorance and of crucial questions for future research.
The format of the proceedings does not follow precisely that of
the Conference itself. The formal papers are included, somewhat ab
breviated, and excerpts of the discussion have been gathered under
a series of topics arranged in logical sequence. Therefore, the
quoted statements do not necessarily appear in order or in the place
in the program where they were made. Principal issues, syntheses
and unanswered questions are interspersed among the topics as edi
torial comments.
The Lindau Conference took place less than six months after the
Second International Symposium on Atherosclerosis in Chicago (Athero
sclerosis, Proceedings of the Second International Symposium, Edited
by Richard J. Jones, Springer-Verlag, New York, Heidelberg, Berlin
1970). Despite the proximity in time and the substantial overlap in
participants, the Lindau meeting reflected a further step in under
standing the pathogenesis of arteriosclerosis. Each presentation of
data was exposed to a more or less leisurely examination and critical
PREFACE
viii
comment by interested participants of varying background and experi
ence. Unfortunately, the remarks of some of the participants did not
come through clearly enough in the tape recording of the Conference
to enable them to be transcribed and included in the Proceedings.
Apologies are therefore offered to these contributors. The full list
of participants follows:
C. W. M. Adams, England C. G. Gunn, USA
Pierre Alaupovic, USA S. Habersang, Germany
Egil Amundsen, Norway Curtis C. Hames, USA
Max Anliker, USA W. H. Hauss, Germany
Felix Anschutz, Germany M. Daria Haust, Canada
Poul Astrup, Denmark Robert Hess, Switzerland
Peter Barth, Germany Siegfried Heyden, USA
Gunnar Biorck, Sweden Alan N. Howard, England
A. Bizzi, Italy D. E. Hyams, England
Per Bjurulf, Sweden Thomas N. James, USA
G. V. R. Born, England Ernst Jokl, USA
G. Bornebusch, Germany Richard J. Jones, USA
C. J. F. Bottcher, Holland G. Junge-Hulsing, Germany
David E. Bowyer, England Ancel Keys, USA
G. S. Boyd, Scotland F. Kief, Germany
Bernard B. Brodie, USA H. Kleinsorge, Germany
Daniel Brunner, Israel G. Klose, Germany
Lars A. Carlson, Sweden D. Kramm, Germany
Cesare Cavallero, Italy W. Krauland, Germany
Paris Constantinides, Canada Franz Kuthan, Switzerland
R. C. Cotton, England Robert Laffan, USA
Allan J. Day, Australia K. Laki, USA
F. Delfs, Germany P. D. Lang, Germany
Ervin G. Erdos,-USA K. T. Lee, USA
R. Finlayson, England Bernard I. Lewis, USA ,
Frank Fremont-Smith, USA J. F. Linhart, Czechoslovakia
John French, England J. Linzbach, Germany
Meyer Friedman, USA Hugh B. Lofland, USA
H. Fritsch, Germany Karl Matthes, Germany
Sven O. Froberg, Sweden Henry C. McGill, Jr., USA
J. Gasser, Switzerland W. Mehrhof, Germany
G. Genthe, Germ~ny W. W. Meyer, Germany
K. F. Gey, Switzerland Tatu Miettinen, Finland
Theodore Gillman, England Pierre Moret, Switzerland
John L. Gordon, England Esko A. Nikkila, Finland
Andres Goth, USA Herbert Nowak, Germany
E. Granzer, Germany Robert M. O'Neal, USA
Donald E. Gregg, USA Robert C. Page, Jamaica, B.W.I.
J. C. Gremaud, Switzerland Frank Parker, USA
G. A. Gresham, England Thomas M. Parkinson, USA
H. Greten, Germany Jeremy D. Pearson, England
J. J. Groen, Holland Th' Pfleiderer, Germany
ix
PREFACE
W. Pollmun, Germany Olga Stein, Israel
Lawrence Pottenger, USA Yechezkiel Stein, Israel
Lina Puglisi, Italy G. Stork, Germany
M. W. Reinheimer, Germany C. Bruce Taylor, USA
J. L. Richard, France H. J. Thomasson, Holland
Abel L. Robertson, USA A. Timms, Switzerland
David D. Rutstein, USA K. Toki, Japan
Sigurd Sailer, Austria Marcel Vastesaeger, Belgium
R. Sanwald, Germany A. J. Vergroesen, Holland
Gotthard Schettler, Germany K. von Berlepsch, Switzerland
Gunter Schlierf, Germany Mark L. Wahlqvist, Sweden
Robert A. Schneider, USA E. Weber, Germany
Hans Schroter, Germany A. Weizel, Germany
Colin J. Schwartz, Canada N. T. Werthessen, USA
P. J. Scott, New Zealand Robert W. Wissler, USA
D. Seidel, Germany Stewart Wolf, USA
D." Sinapius, Germany G. Wolfram, Germany
Elspeth B. Smith, Scotland Ernes t L. Wynder, USA
Jeremiah Stamler, USA Nepomuk Zollner, Germany
The expenses of the Conference and of the preparation of the
Proceedings were covered by generous contributions from the follow
ing organizations and firms:
Alabama Heart Association
American Heart Association
British Heart Fund
Fannie E. Rippel Foundation
Federal Republic of Germany
City of Lindau
Office of Naval Research"
Oklahoma Medical Research Foundation
University of Heidelberg
University of Texas Medical Branch at Galveston
Ayerst Laboratories
Bayer A.G.
Boehringer Mannheim GmbH
CIBA A.G.
CIBA Pharmaceutical CompGny
Deutsche Maizena Werke GmbH
Farbwerke Hoechst A.G.
Hoffman-LaRoche A.G.
Imperial Chemical Industries
Kali-Chemie
Knoll AG
Margarine-Institut fur Gesunde Ernahrung
Merck, Sharp and Dohme Research Laboratories
Nattermann and Cie. GmbH
Sandoz A.G.
PREFACE
x
Sandoz Pharmaceutical
Schering A.G.
G.D. Searle and Co.
Smi th, Kline and French Foundatior,
Squibb and Sons Pharmaceutical
Unilever Research Laboratories
Upjohn Company
Warner-Lambert Foundation
Arrangements for the meeting were accomplished under the direc
tion of Professor Gotthard Schettler and Dr. Gunter Schlierf. The
warm and generous hospitality of our German hosts is gratefully ac
knowledged. The staff for the Conference was led by Mrs. Cora Gillett,
and included Miss Jane Henson, Miss Carol Wehner, Miss Anneke Rieben
and Miss Anita Reinartz. The editing of the Proceedings was greatly
expedited by the able editorial assistance of Miss Helen Goodell, and
by the expert and devoted secretarial work of Miss Jane Henson, who
typed the final manuscript, and who, with Mrs. Barbara Altstatt and
Mrs. Harriet Ross, also managed the lengthy correspondence prelimi
nary to the Conference. Miss Mary Steichen and Miss Elizabeth
Fitzsimmons provided valuable assistance to Miss Henson in organizing
and developing the manuscript. Thanks are offered to all of these
ladies.
CONTENTS
Preface. . . . . • • • . . • • • • . • . • . . • . • . • • . • . • • • • . • • • • • • • • . . • • • . . . • • • • • vii
Chapter 1
THE STRUCTURE OF ARTERIES, GROWTH ADAPTATION AND
REPAIR: THE DILEMMA OF NORMAL........................... 1
Chapter 2
ENDOCRINE, CHEMICAL AND NEURAL REGULATORS AND THE
53
EFFECTS OF AGING.........................................
Chapter 3
LIPID METABOLISM IN THE HUMAN ARTERIAL INTIMA WITH
AGING AND WITH ATHEROSCLEROSIS........................... 81
Chapter 4
LIPID TRANSPORT IN THE NORMAL AND ATHEROMATOUS WALL
OF EXPERIMENTAL ANIMALS.............. • • • • • • • • • • • • • • • • • • • • 121
Chapter 5
LIPID SYNTHESIS WITHIN THE NORMAL AND ATHEROMATOUS
ARTERIAL WALL. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • • 157
Chapter 6
THROMBOGENIC MECHANISMS IN ATHEROSCLEROSIS................... 175
Cbapter 7
ENDOTHELIAL INJURY IN THE PATHOGENESIS OF ARTERIOSCLEROSIS... 185
xi