Chapter 13 - In vitro, primarily microfluidic models for atherosclerosis

Abstract

Atherosclerosis develops over many years, so in vivo and in vitro models are necessary to understand each step in the progression of the disease and to test interventions meant to prevent, halt, or reverse it. While animal models are immensely useful, they do not fully recapitulate the biochemistry or pathology of human disease. Therefore, in vitro models fill an important role, and sophisticated systems for incorporating fluid flow to mimic arterial hemodynamics have developed over the last 40 years. The earliest designs gradually became more complex to include more cell types, stenosis geometry, and disturbed flow regimes. These custom, in vitro flow devices culminated in microfluidic designs in the 2000s once investigators could mold arbitrary geometry at the microscale to finely control cellular exposure to flow. This chapter explores the evolution of in vitro models of atherosclerosis and the variety of hypotheses and results that have emerged from these efforts.