Pathogenesis of Atherosclerosis. Injury of vascular epithelium by oxidized low density lipoproteins (oxidized LDL) or cigarette smoke leads to inflammation of tissue and global DNA-methylation within the cells. Proinflammatory transcription factors like NFκ-B are activated subsequently and expression of endothelial adhesion molecules leads to monocyte adhesion. These cells incooperate large quantities of oxidize d LDLs and become foam cells (forming of atherom). The forming of an atherosclerotic plaque is accompanied by the invasion of the vessel wall by smooth muscle cells (SMCs) and the accumulation of collagens and proteoglycans (Rebuilding of vessel wall).