In Reply We thank Eroğlu and Eroğlu for their interest in our article1 and for discussing endothelial calcium influx as a potential mechanism underlying the observed association between serum monocyte-chemoattractant protein–1 (MCP-1) levels and cardiovascular mortality. While this is an interesting hypothesis, we feel there are limited data to support this. Specifically, it remains unclear whether endothelial calcium influx itself is an event causally related to atheroprogression or simply an epiphenomenon of other causal mechanisms. In contrast, the chemoattractant effect of MCP-1 on circulating monocytes is well established, as is the key role of monocytes in lipoprotein phagocytosis and atheroprogression after migration to the subendothelial space as macrophages.2 Furthermore, MCP-1 has been shown to participate in monocyte egress from bone marrow,3 which might additionally contribute to the recruitment of monocytes toward atherosclerotic plaques.
Georgakis MK, Dichgans M. Serum Monocyte-Chemoattractant Protein–1 Could Be an Indicator of Coronary Artery Calcium Score—Reply. JAMA Cardiol. 2021;6(5):605. doi:10.1001/jamacardio.2021.0073
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