What is Hyaline Arteriolosclerosis?

Instructor: Artem Cheprasov

Artem has a doctor of veterinary medicine degree.

This lesson goes over a very little heard of condition known as hyaline arteriosclerosis. We all have it, but not all of us have to fear it, for now. Find out what it is, how it occurs, and when to be worried.

Hyaline Arteriosclerosis

As we age, we tend to suffer from one problem or another. Heart disease, dementia, and arthritis to name a few. You can add a further problem to that list, called hyaline arteriosclerosis. You might be surprised to learn that even 1-month-olds may have this issue. But is it of serious concern to them or the elderly? You'll find out soon enough.

Regardless, hyaline arteriosclerosis, also called arteriolar hyalinosis, is a term that refers to a specific thickening and hardening of small arteries throughout the body as a result of the accumulation of a 'glassy' substance in their walls. It's a confusing term and a condition about which few have heard of. So, if you want to know more about it, let's dig in!

Definitions & Basic Anatomy

Before we can properly discuss hyaline arteriosclerosis, we need to be onboard with some very basic but important definitions and anatomy.

Hyaline, by itself, is a term that comes to us from the Greek word for glass. In other words, something hyaline appears glassy under the microscope. It also has a pink color under the microscope when a routine, H&E, stain is used to visualize it.

Arteriosclerosis is a broad term for the thickening and hardening of arterial walls, of which there can be more than one cause and form.

This image shows atherosclerosis, the most famous form of arteriosclerosis.
This image shows atherosclerosis, the most famous form of arteriosclerosis.

An artery is a blood vessel that carries oxygenated blood and nutrients to an organ or tissue. This is important to remember for later.

Each artery has an inner layer called the endothelium. This layer of cells is the one that comes into contact with the blood within the artery. In other words, if the artery is like a pipe, then if you were to stick your finger inside the pipe and touch it from the inside, you'd be touching the pipe's endothelium.

The endothelium is the innermost layer of the artery.
The endothelium is the innermost layer of the artery.

Pathophysiology

Now you're ready to understand the basic mechanisms behind hyaline arteriosclerosis.

Floating around in your blood stream are numerous types of proteins. Some of these proteins are called complement proteins, like C3. These are proteins involved in your immune system. Like a strainer for large fruits is permeable or 'leaky', to grains of rice, the endothelium of small arteries of the body is permeable to blood proteins roughly the size of C3.

Once C3 enters into the arterial wall, it spontaneously changes to another protein called C3b. The problem is that the arterial wall, especially the subendothelium, is rich in something called hyaluronic acid (HA). The subendothelium is the part of the arterial wall immediately underneath ('sub') the endothelium. Hyaluronic acid is a kind of sugar-based substance that acts as a binding and lubricating agent.

Anyways, due to a favorable energetic biochemical reaction, C3b binds to HA and forms a 'glassy', or hyaline, precipitate. This precipitation may begin in one small area, but it will eventually spread out and involve the entire circumference of the artery and even the deeper layers of the arterial wall, leading to the thickening and hardening of the arterial walls, arteriosclerosis. Hence the term, hyaline arteriosclerosis.

Hyaline arteriosclerosis is commonly found in the smaller arteries of the following organs and tissues:

  • Spleen
  • Kidneys
  • Liver
  • Brain
  • Pancreas
  • Adrenal glands
  • Intestinal tract
  • Retina

Causes & Consequences

Hyaline arteriosclerosis is a relatively common, and most likely unpreventable, degenerative change seen in the human body. In other words, it's pretty much unavoidable as our tissues wear down over time. Evidence of hyaline arteriosclerosis in the spleen has been observed in infants as young as 1-month-old, and it becomes common by age 4-5 and almost certain by old age.

In most people, hyaline arteriosclerosis is of no significant medical consequence. This is especially true for the young and otherwise healthy individuals.

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