Research is finding that within atherosclerosis plaque there is an immune reaction that triggers intense inflammation in artery walls. When the wall of an artery is injured (as they are by hypertension, diabetes, insulin resistance, etc.), inflammatory fats begin to accumulate just beneath the endothelial layer, which disrupts the cells. These accumulating fats are highly inflammatory, and trigger special immune cells called macrophages to migrate to the site of the inflammation.

You can think of macrophage cells as being like the Pac-Man video game character — they gobble up fat in the injured vessel cells (called foam cells) in an attempt to reduce inflammation. But if the fat accumulation is excessive, foam cells can become so engorged that they burst, releasing the inflammatory, oxidized fat back into the wall of the artery. This triggers even more macrophage cells to come to the site.

Other immune cells also migrate. This is the mechanism that creates the boil-like structure Dr. Virchow described in 1850.

Because massive numbers of immune cells are involved in atherosclerosis, some have proposed that the cause is an autoimmune reaction localized to the interior of arteries.

As with autoimmune disorders, within the plaque we see a rise in inflammatory cytokines such as IL-6, TNF-alpha, IL-2, and IFN-gamma. In essence, an intense immune reaction is taking place within atherosclerotic plaque.

Studies have shown that reducing the inflammation reduces the growth of the plaque and can reduce the risk of atherosclerosis. Among other natural compounds, omega-3 oils accomplish this quite efficiently.