Early-life inflammation pathways trigger a cascade leading to development of atherosclerotic plaque through the "butterfly effect" - An hypothesis.

Atherosclerosis is a common disease whose complications, such as myocardial infarction, are a leading cause of mortality worldwide. Therefore, ideas which try to explain the circumstances of atherosclerotic plaque initiation and progression are warranted. We hypothesize that low-grade inflammation in early life (especially an imbalance between pro- and anti-inflammatory macrophages) triggers a "butterfly effect" within the arterial wall by initiating a sequence of processes that finally leads to atherosclerotic plaque development and progression. Therefore, pharmacological and non-pharmacological interventions aimed to prevent atherosclerosis development should be applied not only in the adult population over 40 years old (according to current American and European guidelines) but should start in early life.
(Copyright © 2018. Published by Elsevier Ltd.)