In order to study the morphogenesis of atherosclerosis, human aortas at various ages from embryo to 86 years were investigated pathologically, pathohistologically and histochemically. At the same time, experimental atherosclerosis in cholesterol-fed rabbits which were bred in normal stock diet for 18 months afier cessation of cholesterol feeding were compared with those of human subjects. Further in order to examine the thrombogenic theory concerning genesis of atherosclerosis, reduplicate observation was made by Duguid method.
1) Intirnal thickening of the human aorta with ageing was observed from embryonal stage.
2) Arteriosclerosis of the aorta was remarkable in the abdominal aorta which showed great development of intima with ageing, and was mild in the ascending aorta which showed weak one. Consequently it is considered that a common factor may be involved both in diffuse intimal thickening with ageing and development of atherosclerosis.
3) Atherosclerosis is observed approximately at age above 50, but it appears ten years earlier in the hypertensives.
4) The early lesion of arteriosclerosis is intimal edema; atherosclerosis develops from it by insudation of blood plasma rich in lipid and fibrous plaque is produced from it when is is poor in lipid.
5) The precursor of atherosclerosis is intimal lipoidosis (fatty streaks or fatty spots). Lipid accumulated in the intima consists of lipid insudated directly from the circulating blood and of cellular lipids (foam cells and smooth muscle cells).
6) Pathohistologically, there are two types of atherosclerosis-type α which mainly consists in fatty swelling of collagen fiber and type β which mainly consists in tissue debris. The type α develops when intima contains poor lipids and rich collagen fibers and the type β is produced when it contains rich lipids and few collagen fibers. Foam cells play a very important role in the formation of type β atherosclerosis.
7) In order to investigate the significance of thrombi in the morphogenesis of atherosclerosis, the aortas of 50 autopsy cases ranging in age from 10 to 81 were studied. There were, however, no findings which indicate that thrombus played a principal role in the morphogenesis of atherosclerosis.
8) The rabbit which was first raised on 1 per cent cholesterol diet for 14-17 weeks and then on normal stock diet for 61 weeks at the longest, showed the closely slmilar change-to human atherosclerosis, especially of type β.
9) In the rabbit raised by the daily administration of the diet containing 6 g lard for a year, atherosclerosis does not appear. Therefore neutral fat is not involved in the formation of atherosclerosis, but the participation of cholesterol has an important significance.
View full abstract