The geography of human plaque stability: who talks to whom – and where

Spatial transcriptomics reveals a key role of fibroblast-like vascular smooth muscle cells in human atherosclerotic cell crosstalk and stability

European Heart Journal

Why do some atherosclerotic plaques remain silent while others trigger events? By combining spatial and single-cell transcriptomics in human carotid plaques, Gonçalves et al. created the first comprehensive spatial map of ligand-receptor communication across distinct regions of human carotid plaques, preserving not only which cells interact, but also where those signals occur.

The analyses identified fibroblast-like vascular smooth muscle cells as central coordinators of protective crosstalk within the fibrous cap. These matrix-producing cells were enriched in stable, asymptomatic plaques and associated with fewer future cardiovascular events longitudinally. Mapping where protective cell states reside could refine plaque-risk stratification and reveal new therapeutic targets.

Explore how the "geography" of plaque biology may bring precision prevention or new targeted treatment closer to clinical practice.