Studies on the Pathogenesis of Vascular Disease

That diet and the state of the blood lipids are in some way related to the establishment of arteriosclerosis is supported by voluminous epidemiological, clinical, and experimental evidence, but the exact roles of these factors in the pathogenesis of this important disease have not been clarified. In this laboratory, experiments have demonstrated that lipids from the ambient plasma, derived either from chylomicrons or from lipoproteins, localize and accumulate selectively at the sites of acute inflammatory lesions experimentally produced in the coronary arteries of animals." It was emphasized that such localization of lipids is dependent, within wide ranges of blood lipid levels, upon the presence of the inflammatory arterial foci. With certain lipids and in certain circumstances, transformations of the basic arterial lesions to fatty, foam-cellular granulomas, similar to those of arteriosclerosis, have been observed. However, acute inflammatory foci in muscular vessels such as the dog's coronary arteries can hardly serve as pathogenetic models for the intimas of the elastic arteries of man, in which arteriosclerosis preferentially develops. The living cornea has seemed to be a more suitable site for the study of connective tissue-lipid interactions of interest in the pathology of chronic vascular disease. Background exists for such an approach. In the course of studies of mustard gas injuries of the eyes in men and in experimental animals, Mann and Pullinger8'9 in 1942 called attention to occasional deposits of cholesterol and of other lipids in the corneal lesions. These deposits were associated with vascularization from the limbus and were often accompanied by hemorrhage or by ulceration. Mann and Pullinger suggested that certain of the lipid-connective tissue reactions occurring in the cornea resembled those in