Atherosclerosis, a major contributor to cardiovascular disease is a global alarm causing mortality worldwide.
Being a progressive disease in the arteries, it mainly causes recruitment of monocytes to the inflammatory sites and subside
pathological conditions. Monocyte-derived macrophage mainly acts in foam cell formation by engorging the LDL
molecules, oxidizes it into Ox-LDL and leads to plaque deposit development. Macrophages in general differentiate,
proliferate and undergo apoptosis at the inflammatory site. Frequently two subtypes of macrophages M1 and M2 has to act
crucially in balancing the micro-environmental conditions of endothelial cells in arteries. The productions of proinflammatory mediators like IL-1, IL-6, TNF-α by M1 macrophage has atherogenic properties majorly produced during the
early progression of atherosclerotic plaques. To counteract cytokine productions and M1-M2 balance, secondary metabolites
(phytochemicals) from plants act as a therapeutic agent in alleviating atherosclerosis progression. This review summarizes
the fundamental role of the macrophage in atherosclerotic lesion formation along with its plasticity characteristic as well as
recent therapeutic strategies using herbal components and anti-inflammatory cytokines as potential immunomodulators.
Keywords: Atherosclerosis, macrophages, Ox-LDL (oxidized low-density lipoprotein), cytokines, immunomodulators, curcumin.
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