Peli1 plays a protective role in atherosclerosis as its deficiency increases pathogenic immune cell subsets (Th1 cells and Tfh cells)and decreases protective subsets (Treg and Breg cells), promoting systemic inflammation, immune cell infiltration, and foam cell formation in vascular smooth muscle cells, thereby exacerbating atherosclerosis (131). This evidence concerns the gene PELI1 and atherosclerosis.