Decreased autophagy is associated with reduced CysC levels in progression of human atheroma. Representative photographs of autofluorescence of ceroid, Atg5 (brown), double immunohistochemistry of p62/SQSTM1 (brown) and CD68 (red), ubiquitin (brown) and CysC (brown) in situ in early lesions (left panels) and advanced human carotid lesions (middle panels); bars = 50 μm. Note: In early lesion areas, there are very low levels of ceroid, significantly higher levels of Atg5 and significantly lower levels of p62/SQSTM1 in CD68‐positive macrophages and low levels of ubiquitin, while advanced lesions show pronounced ceroid accumulation, low Atg5 and massive accumulation of CD68‐positive macrophages with significant increased levels of p62/SQSTM1 and ubiquitin and lower levels of CysC. Histograph show quantification of immunopositive areas of Atg5, p62/SQSTM1, ubiquitin and CysC. *P < 0.05, **P < 0.01.