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@doctorstotrust
presents episode 1922 | DR BEN BIKMAN [insulin whisperer]

The heart, in order to continuously contract and expand,
needs a lot of blood...feeding the heart are coronary
arteries: which can become blocked with plaques…
Plaques consist of fat, foam cells. but
-we don't know exactly what is happening
-any speaking of how these are formed is speculation
Foam cells appear to be essential
-they are always there at plaque
-we believe they are involved in formation
-we know inflammation is a major factor
-LDL is a terrible predictor of heart disease

C-reactive protein, a marker of inflammation…
-is a better predictor of heart disease
Macrophages, immune cells, can go into any cell in body
In blood vessel wall, we have macrophage that
-engulfs an LDL cholesterol
-as it eats too many, it becomes fat
-fat in macrophage look like air bubbles [looks foamy]
-foam cell is a fat macrophage
-begins to secrete pro-inflammatory
proteins [cytokines]
example: C-reactive protein

Foam cells seem to be active player in plaque formation…
Study, 1979, Brown & Goldstein, incubate macrophages
-with LDL cholesterol [native, NOT sdLDL]
-they Could Not Make Macrophage Eat the LDL
-they simply hanged out together
Only altered LDL particles could be eaten by macrophage
-sensing the altered LDL as a problem,
Macrophage engulfed it
therefore, something must happen to
LDL for it to be the problem

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