Pathobiology 2027

Today, we understand the pathogenesis of atherosclerosis as the complex and dynamic interaction of numerous cellular and molecular process, including lipid metabolism, inflammation, systemic clonal mutations, cellular trans differentiation, and biomechanical forces. Together, these forces govern a unique arterial wall microenvironment leading to formation of plaque, with diagnostically important histologic features. This symposium will feature experts discussing their recent exciting advances in two of these processes that dictate plaque development, and a novel diagnostic imaging technique to detect plaque vulnerable to rupture. First, Dr. Robert Wirka leverages large-scale Genome-Wide Association Studies (GWAS) and single-cell RNA sequencing to decipher the complex life cycle of resident vascular cells. He will discuss how specific causal coronary artery disease genes dictate whether a smooth muscle cell transitions into a protective fibrous cap phenotype or a disease-driving alternative fate, offering critical insights into plaque stability. Second, Dr. Alan Tall has illuminated how Clonal Hematopoiesis of Indeterminate Potential accelerates atherosclerosis and will guide us through the molecular mechanisms by which these mutant hematopoietic stem cells hyper-activate macrophage inflammasomes and drive necrotic core formation. Third, Dr. Caterina Gallippi develops pioneering Acoustic Radiation Force (ARF)-based imaging techniques and ultrasound elastography to non-invasively interrogate the mechanical and viscoelastic properties of tissues. She will discuss how ARF-imaging will allow clinicians to precisely delineate the composition, stiffness, and vulnerability of carotid atherosclerotic plaques, transforming stroke risk prediction and patient monitoring without the need for radiation. Please join us for this multi-scale view of the modern fight against cardiovascular disease.