Macrophages play a crucial role in sustaining chronic inflammation in atherosclerosis (AS) and are a hallmark of atherosclerotic plaques. They undergo differentiation into distinct subpopulations under the influence of oxidized lipids and cytokines, exerting various functions in plaque formation and progression. To examine the variations in the quantity and distribution of different macrophage subpopulations surrounding distinct pathological features of carotid plaques in human AS. Based on these findings, we seek to explore the potential correlations between specific macrophage subpopulations and AS pathological characteristics. Initially, we analyzed single-cell RNA sequencing (scRNA-Seq) data obtained from the GEO DataSets (GSE159677). The results revealed a significant infiltration of macrophages in AS, categorizing them into distinct subpopulations with diverse transcriptional features and functions. Furthermore, in different regions of AS (i.e., calcified AS core vs. proximal adjacent areas), both the total number of macrophages and the subpopulation ratios exhibited variations. Subsequently, we examined the distribution differences of macrophage subpopulations within 61 surgically resected AS plaques using marker staining techniques such as CD68, iNOS, Arg-1, CD163, and HO-1. The findings demonstrated that macrophages predominantly localized in specific pathological lesions, including necrosis, fibrous tissue degeneration, and cholesterol crystallization. Moreover, distinct subpopulations exhibited differential distribution patterns within these lesions. This study provides confirmation of extensive macrophage infiltration within atherosclerotic plaques, highlighting the presence of subtypes that exhibit variability across different pathological lesions. These results suggest that various macrophage subpopulations may contribute differently to distinct pathological lesions in AS.
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