Accumulating evidence suggests that dendritic cells (DCs) play a crucial role in the generation and progression of atherosclerosis (ATS), a lipid-related immuno-inflammatory disease. DCs have the ability to process and present antigens (mainly oxidized low-density lipoproteins, heat shock proteins and fragments of necrotic or apoptotic cells) to naive T cells, and the activation of T cells is a key step for the progression of atherosclerotic disease. The existence of some distinct DC subtypes has now become evident. The main categories of DC subsets are the 'conventional or myeloid' and the 'plasmacytoid', which differ in toll-like receptor type and site of expression, pathogens and antigens recognized, and effector cytokines and functions. Studies on the potential impact of DCs in the pathogenesis of ATS may lead to novel therapies to regulate the immunoreactions occurring in atherogenesis. In particular, diltiazem, peroxisome proliferator activated receptor agonists and statins have been shown to protect endothelial cell function by inhibiting DCs, a mechanism that may play a significant role in the prevention of ATS.
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