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In recent years, atherosclerosis pathophysiology has evolved from a lipid\u2010based to an inflammation\u2010centric ideology.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This narrative review is comprised of review and original articles that were found through the PubMed search engine. The following search terms or amalgamation of terms were used: \u201ccardiovascular disease,\u201d \u201catherosclerosis,\u201d \u201cinflammation,\u201d \u201cGRP78,\u201d \u201cHsp60,\u201d \u201coxidative low\u2010density lipoproteins,\u201d \u201caldehyde dehydrogenase,\u201d \u201c\u03b22\u2010glycoprotein,\u201d \u201clipoprotein lipase A,\u201d \u201chuman cytomegalovirus.\u201d \u201cSARS\u2010CoV\u20102,\u201d \u201c<jats:italic>chlamydia pneumonia<\/jats:italic>,\u201d \u201cautophagy,\u201d \u201cthrombosis\u201d and \u201ctherapeutics.\u201d<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Emerging evidence supports the concept that atherosclerosis is associated with the interaction between cell surface expression of stress response chaperones, including GRP78 and Hsp60, and their respective autoantibodies. Moreover, various other autoantigens and their autoantibodies have displayed a compelling connection with the development of atherosclerosis, including oxidative low\u2010density lipoproteins, aldehyde dehydrogenase, \u03b22\u2010glycoprotein and lipoprotein lipase A. Atherosclerosis progression is also concurrent with viral and bacterial activators of various diseases. This narrative review will focus on the contributions of human cytomegalovirus as well as SARS\u2010CoV\u20102 and <jats:italic>chlamydia pneumonia<\/jats:italic> in atherosclerosis development. Notably, the interaction of an autoantigen with their respective autoantibodies or the presence of a foreign antigen can enhance inflammation development, which leads to atherosclerotic lesion progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We will highlight and discuss the complex role of the interaction between autoantigens and autoantibodies, and the presence of foreign antigens\u2009in the development of atherosclerotic lesions in relationship to pro\u2010inflammatory responses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14169","type":"journal-article","created":{"date-parts":[[2024,1,30]],"date-time":"2024-01-30T04:29:55Z","timestamp":1706588995000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Fatal attractions that trigger inflammation and drive atherosclerotic 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