Fig. 7.

CMA is part of the systemic and vascular response against proatherosclerotic insults. The protective effect of CMA against atherosclerosis results from the combination of systemic and vasculature-specific functions of CMA. (Left) Systemic CMA failure leads to defective lipid and glucose metabolism that increases systemic vulnerability to the metabolic syndrome. (Right) Defective CMA in VSMCs makes them prone to dedifferentiation because of failure to degrade proteins involved in cellular proliferation, collagen secretion, and cell death. Macrophages unable to up-regulate CMA in response to a lipotoxic stimulus acquire a more proinflammatory phenotype with higher NO levels and LPS signaling and with increased migratory capability.