Cardiovascular diseases (CVDs), largely due to atherosclerosis, are the major causes of death in today’s world. Atherosclerosis
is a chronic inflammatory condition initiated by retention and accumulation of cholesterol-containing lipoproteins, in particular lowdensity
lipoprotein (LDL), in the artery wall. This initiates pathological responses of immune cells that lead to atherosclerotic plaque
formation. T cells are present during all stages of the disease, and play an essential role in the initiation and progression of plaques.
Whereas most T effector cell responses have been suggested to aggravate atherosclerosis, regulatory T cells (Tregs) have been shown to
limit inflammation and inhibit the formation of lesions. In addition to their effects on the local pathological process, T cells and their released
mediators modulate systemic lipid metabolism and can increase risk of CVDs. Such knowledge on the pathological and protective
function of these cells has led to significant advances in the field. This review examines experimental and pre-clinical studies approaching
the manipulation of cellular immunity in atherosclerosis. Modulation of T cells responses by vaccination, antibody therapies, dendritic
cell based-therapies, and using amino acid-derived metabolites have shown benefits against atherosclerotic plaque progression in
animal models. The clinical benefit of T cell-based therapies in humans still requires further investigation.