It is well known that atherosclerosis-the disease characterized by fatty deposits in the arteries-is often a precursor to heart attack or stroke. But what happens at the level of the cells, and even the molecules, to trigger the buildup in the first place?
Scientists at Mount Sinai are investigating precisely such questions. Led by Juan José Badimon, Ph.D., Professor of Medicine, the Cardiovascular Biology Research Laboratory is one of the facilities investigating the role of lipids and thrombosis in the cardiovascular diseases and has recently begun studying the role of programmed cell death (apoptosis) and tissue factor, the cellular agent that initiates clotting, in triggering the thrombotic complications of atherosclerotic disease.
Recently, Dr. Badimon and colleagues have also initiated studies on the regeneration of cardiac tissue, developing an experimental porcine model of acute myocardial infarction to study the effectiveness of various therapeutic approaches. The research group led by Pedro Moreno, M.D., Associate Professor of Medicine and Interventional Cardiologist in the Cardiac Catheterization Laboratory, has recently demonstrated that advanced complicated plaques create their own blood supply by forming tiny capilaries, called microvessels. Because these microvessels contribute to the progression of atherosclerosis by supplying oxygen to the plaque-forming cells, halting or reversing their development constitutes a novel target for current and future therapy in the fight against heart disease.
Another important perspective on the causes of atherosclerosis involves a group of proteins, called chemokines, that are secreted by inflammatory cells. This exploration of the interaction of the immune and cardiovascular systems is the focus of the team led by Alison D. Schecter, M.D., Assistant Professor of Medicine. Dr. Schecter’s group has also elucidated the role of the AIDS virus in stimulating atherosclerosis and thrombosis, using gene chip technology to identify genes that are activated by exposure to HIV.
A very different avenue of inquiry involves identifying genes that underlie cardiovascular disease. This is the focus of Bruce Gelb, M.D., the Arthur J. and Nellie Z. Cohen Professor of Pediatrics, Professor of Human Genetics, and Co-Director of the Cardiovascular Genetics Program, who is particularly studying traits that result in abnormally formed hearts. “Most of these problems are apparent in infants and young children,” says Dr. Gelb, “but others can present in adulthood.” Once the culprit genes are identified, his group creates animal models that can be studied to better understand and then treat the disease.