Topic: Inflammation and Immunity in Atherosclerosis

The paradigm of atherosclerosis has fundamentally shifted from a simple lipid-storage disease to a complex, chronic inflammatory disorder driven by the immune system. Today, this disease is viewed as a chronic inflammatory process inextricably linked to the fundamental biological aging of the cardiovascular system. Cardiovascular aging is a key determinant of vascular susceptibility to atherosclerosis, involving endothelial dysfunction, vascular smooth muscle cell senescence, extracellular matrix remodeling, mitochondrial dysfunction, and impaired vascular repair and regeneration. Vascular aging is characterized by a loss of arterial elasticity, cellular senescence, and the depletion of the regenerative cell pool, creating a fertile ground for chronic inflammation. These age-related changes can reshape the vascular immune microenvironment and amplify inflammatory and immune responses, thereby accelerating atherosclerotic lesion formation and progression. From the initial endothelial dysfunction to the catastrophic rupture of vulnerable plaques, innate and adaptive immune responses dictate every stage of atherogenesis.

While landmark clinical trials have validated the "inflammatory hypothesis" by demonstrating that targeted anti-inflammatory therapies reduce cardiovascular events, critical gaps remain. We still face the challenge of identifying precise molecular targets that suppress vascular inflammation without compromising systemic immunity. A deeper understanding of how biological aging, cellular senescence, and immune dysregulation interact may reveal new therapeutic opportunities for targeting atherosclerosis in aging populations.

To address these pivotal challenges, this upcoming special issue, "Inflammation and Immunity in Atherosclerosis," will bring together cutting-edge research and comprehensive reviews. The forthcoming collection should explore novel mechanisms in immunometabolism, cellular crosstalk within the vascular wall and the interplay between inflammation, immunity, and cardiovascular aging, as well as the emerging role of clonal hematopoiesis. Furthermore, it will highlight innovative diagnostic biomarkers of vascular inflammation and biological aging and translationally viable therapeutic strategies designed to advance personalized cardiovascular medicine.

The primary goal of this issue is to demonstrate how a deep understanding of the molecular mechanisms underlying inflammation, immune dysregulation, atherosclerosis, and cardiovascular aging can pave the way for fundamentally new treatment approaches. Particular attention will be given to how vascular aging, cellular senescence, chronic inflammation, and immune dysfunction contribute to atherosclerotic progression and age-related cardiovascular disease, aiming not merely to slow disease progression but to promote vascular health and restoration. We anticipate that these insights will inspire continued interdisciplinary collaboration to curb the global burden of cardiovascular disease. We look forward to welcoming contributions from leading experts to make this special issue a milestone in cardio-immunology, atherosclerosis, and cardiovascular aging research.