Search This Blog

Wednesday, October 27, 2021

Revolutions of 1848

From Wikipedia, the free encyclopedia

Anarcho-communism also known as anarchist communism, is a political philosophy and anarchist school of thought which advocates the abolition of the state, capitalism, wage labour, social hierarchies and private property (while retaining respect for personal property, along with collectively-owned items, goods and services) in favor of common ownership of the means of production and direct democracy as well as a horizontal network of workers' councils with production and consumption based on the guiding principle "From each according to his ability, to each according to his needs". Some forms of anarcho-communism such as insurrectionary anarchism are strongly influenced by egoism and radical individualism, believing anarcho-communism to be the best social system for the realization of individual freedom. Most anarcho-communists view anarcho-communism as a way of reconciling the opposition between the individual and society.

Anarcho-communism developed out of radical socialist currents after the French Revolution but it was first formulated as such in the Italian section of the First International. The theoretical work of Peter Kropotkin took importance later as it expanded and developed pro-organizationalist and insurrectionary anti-organizationalist sections. To date, the best-known examples of anarcho-communist societies (i.e. established around the ideas as they exist today and achieving worldwide attention and knowledge in the historical canon) are the anarchist territories during the Spanish Revolution and the Free Territory during the Russian Revolution, where anarchists such as Nestor Makhno worked to create and defend anarcho-communism through the Revolutionary Insurrectionary Army of Ukraine. During the Russian Civil War, anarchists in Ukraine rose up against both the Red and White army establishing the Free Territory, with the main ideology being anarcho-communism and anarcho-collectivism based on Peter Kropotkin's works establishing an autonomous zone over most of Ukraine, from 1918 to 1921. Beating back both White and Red Army, before later being attacked and invaded by the Bolsheviks in 1921.

In 1929, anarcho-communism was implemented in Korea by the Korean Anarchist Federation in Manchuria (KAFM) and the Korean Anarcho-Communist Federation (KACF), with help from anarchist general and independence activist Kim Chwa-chin, lasting until 1931, when Imperial Japan assassinated Kim and invaded from the south, while the Chinese Nationalists invaded from the north, resulting in the creation of Manchukuo, a puppet state of the Empire of Japan. Through the efforts and influence of the Spanish anarchists during the Spanish Revolution within the Spanish Civil War starting in 1936, anarcho-communism existed in most of Aragon, parts of the Levante and Andalusia as well as in the stronghold of anarchist Catalonia before being crushed in 1939 by the combined forces of the Francoist Nationalists (the regime that won the war), Nationalist allies such as Adolf Hitler and Benito Mussolini and even Spanish Communist Party repression (backed by the Soviet Union) as well as economic and armaments blockades from the capitalist states and the Spanish Republic itself governed by the Republicans.

History

Early precursors

The Diggers are often seen as the first practicing anarchists, having held common ownership over land and resources around the time of the English Civil War
 
Lahontan's 1703 novel documented the author's experiences with various indigenous American tribes and cultures. The novel explores various agrarian socialist societies and how they were able to provide property for all their inhabitants through collective ownership. The recurring theme of these many cultures were their non-hierarchical structure, early egalitarian styles of living and how mutual aid played a significant role in maintaining health.
 
Sylvain Maréchal, 18th-century atheist philosopher and whose egalitarian beliefs pre-staged ideological developments of anarchism and utopian socialism

Anarcho-communist currents appeared during the English Civil War and the French Revolution of the 17th and 18th centuries, respectively. Gerrard Winstanley, who was part of the radical Diggers movement in England, wrote in his 1649 pamphlet The New Law of Righteousness that there "shall be no buying or selling, no fairs nor markets, but the whole earth shall be a common treasury for every man" and "there shall be none Lord over others, but every one shall be a Lord of himself".

The Diggers themselves resisted tyranny of the ruling class and of kings, instead operating in a cooperative fashion in order to get work done, manage supplies, and increase economic productivity. Due to the communes established by the Diggers being free from private property, along with economic exchange (all items, goods and services were held collectively), their communes could be called early, functioning communist societies, spread out across the rural lands of England.

Prior to the Industrial Revolution, common ownership of land and property was much more prevalent across the European continent, but the Diggers were set apart by their struggle against monarchical rule. They sprung up by means of workers' self-management after the fall of Charles I.

In 1703, Louis Armand, Baron de Lahontan wrote the novel New Voyages to North America where he outlined how indigenous communities of the North American continent cooperated and organised. The author found the agrarian societies and communities of pre-colonial North America to be nothing like the monarchical, unequal states of Europe, both in their economic structure and lack of any state. He wrote that the life natives lived was "anarchy", this being the first usage of the term to mean something other than chaos. He wrote that there were no priests, courts, laws, police, ministers of state, and no distinction of property, no way to differentiate rich from poor, as they were all equal and thriving cooperatively.

During the French Revolution, Sylvain Maréchal, in his Manifesto of the Equals (1796), demanded "the communal enjoyment of the fruits of the earth" and looked forward to the disappearance of "the revolting distinction of rich and poor, of great and small, of masters and valets, of governors and governed". Maréchal was critical not only of the unequal distribution of property, but how religion would often be used to justify evangelical immorality. He viewed the link between religion and what later came to be known as capitalism (though not in his time) as two sides of the same corrupted coin. He had once said, "Do not be afraid of your God - be afraid of yourself. You are the creator of your own troubles and joys. Heaven and hell are in your own soul".

Sylvain Maréchal was personally involved with the Conspiracy of the Equals, a failed attempt at overthrowing the monarchy of France and establishing a stateless, agrarian socialist utopia. He worked with Gracchus Babeuf in not only writing about what an anarchist country might look like, but how it will be achieved. The two of them were friends, though didn't always see eye to eye, particularly with Maréchal's statement on equality being more important than the arts.

Joseph Déjacque and the Revolutions of 1848

An early anarchist communist was Joseph Déjacque, the first person to describe himself as "libertarian". Unlike Proudhon, he argued that, "it is not the product of his or her labor that the worker has a right to, but to the satisfaction of his or her needs, whatever may be their nature". According to the anarchist historian Max Nettlau, the first use of the term libertarian communism was in November 1880, when a French anarchist congress employed it to more clearly identify its doctrines. The French anarchist journalist Sébastien Faure, later founder and editor of the four-volume Anarchist Encyclopedia, started the weekly paper Le Libertaire (The Libertarian) in 1895.

Déjacque rejected Blanquism, which was based on a division between the 'disciples of the great people's Architect' and 'the people, or vulgar herd,' and was equally opposed to all the variants of social republicanism, to the dictatorship of one man and to 'the dictatorship of the little prodigies of the proletariat.' With regard to the last of these, he wrote that: 'a dictatorial committee composed of workers is certainly the most conceited and incompetent, and hence the most anti-revolutionary, thing that can be found [...] (It is better to have doubtful enemies in power than dubious friends)'. He saw 'anarchic initiative,' 'reasoned will' and 'the autonomy of each' as the conditions for the social revolution of the proletariat, the first expression of which had been the barricades of June 1848 (see Revolutions of 1848). In Déjacque's view, a government resulting from an insurrection remains a reactionary fetter on the free initiative of the proletariat. Or rather, such free initiative can only arise and develop by the masses ridding themselves of the 'authoritarian prejudices' by means of which the state reproduces itself in its primary function of representation and delegation. Déjacque wrote that: 'By government I understand all delegation, all power outside the people,' for which must be substituted, in a process whereby politics is transcended, the 'people in direct possession of their sovereignty,' or the 'organised commune.' For Déjacque, the communist anarchist utopia would fulfil the function of inciting each proletarian to explore his or her own human potentialities, in addition to correcting the ignorance of the proletarians concerning 'social science'".

International Workingmen's Association

Carlo Cafiero, first person to break away from Mikhail Bakunin's collectivist anarchism and advocate anarchy and communism

As a coherent, modern economic-political philosophy, anarcho-communism was first formulated in the Italian section of the First International by Carlo Cafiero, Emilio Covelli, Errico Malatesta, Andrea Costa and other ex Mazzinian republicans. The collectivist anarchists advocated remuneration for the type and amount of labor adhering to the principle "to each according to deeds", but they held out the possibility of a post-revolutionary transition to a communist system of distribution according to need. As Mikhail Bakunin's associate James Guillaume put it in his essay Ideas on Social Organization (1876): "When [...] production comes to outstrip consumption [...] everyone will draw what he needs from the abundant social reserve of commodities, without fear of depletion; and the moral sentiment which will be more highly developed among free and equal workers will prevent, or greatly reduce, abuse and waste".

The collectivist anarchists sought to collectivize ownership of the means of production while retaining payment proportional to the amount and kind of labor of each individual, but the anarcho-communists sought to extend the concept of collective ownership to the products of labor as well. While both groups argued against capitalism, the anarchist communists departed from Proudhon and Bakunin, who maintained that individuals have a right to the product of their individual labor and to be remunerated for their particular contribution to production. However, Errico Malatesta stated that "instead of running the risk of making a confusion in trying to distinguish what you and I each do, let us all work and put everything in common. In this way each will give to society all that his strength permits until enough is produced for every one; and each will take all that he needs, limiting his needs only in those things of which there is not yet plenty for every one".

In Anarchy and Communism (1880), Carlo Cafiero explains that private property in the product of labor will lead to unequal accumulation of capital and therefore the reappearance of social classes and their antagonisms; and thus the resurrection of the state: "If we preserve the individual appropriation of the products of labour, we would be forced to preserve money, leaving more or less accumulation of wealth according to more or less merit rather than need of individuals". At the Florence Conference of the Italian Federation of the International in 1876, held in a forest outside Florence due to police activity, they declared the principles of anarcho-communism as follows:

The Italian Federation considers the collective property of the products of labour as the necessary complement to the collectivist programme, the aid of all for the satisfaction of the needs of each being the only rule of production and consumption which corresponds to the principle of solidarity. The federal congress at Florence has eloquently demonstrated the opinion of the Italian International on this point.

The above report was made in an article by Malatesta and Cafiero in the Swiss Jura Federation's bulletin later that year.

Peter Kropotkin

Peter Kropotkin (1842–1921), often seen as the most important theorist of anarchist communism, outlined his economic ideas in The Conquest of Bread and Fields, Factories and Workshops. Kropotkin felt that cooperation is more beneficial than competition, arguing in his major scientific work Mutual Aid: A Factor of Evolution that this was well-illustrated in nature. He advocated the abolition of private property (while retaining respect for personal property) through the "expropriation of the whole of social wealth" by the people themselves, and for the economy to be co-ordinated through a horizontal network of voluntary associations where goods are distributed according to the physical needs of the individual, rather than according to labor. He further argued that these "needs," as society progressed, would not merely be physical needs but "[a]s soon as his material wants are satisfied, other needs, of an artistic character, will thrust themselves forward the more ardently. Aims of life vary with each and every individual; and the more society is civilized, the more will individuality be developed, and the more will desires be varied." He maintained that in anarcho-communism "houses, fields, and factories will no longer be private property, and that they will belong to the commune or the nation and money, wages, and trade would be abolished".

Individuals and groups would use and control whatever resources they needed, as the aim of anarchist communism was to place "the product reaped or manufactured at the disposal of all, leaving to each the liberty to consume them as he pleases in his own home". He supported the expropriation of private property into the commons or public goods (while retaining respect for personal property) to ensure that everyone would have access to what they needed without being forced to sell their labour to get it, arguing:

We do not want to rob any one of his coat, but we wish to give to the workers all those things the lack of which makes them fall an easy prey to the exploiter, and we will do our utmost that none shall lack aught, that not a single man shall be forced to sell the strength of his right arm to obtain a bare subsistence for himself and his babes. This is what we mean when we talk of Expropriation [...].

— Peter Kropotkin, The Conquest of Bread

He said that a "peasant who is in possession of just the amount of land he can cultivate" and "a family inhabiting a house which affords them just enough space [...] considered necessary for that number of people" and the artisan "working with their own tools or handloom" would not be interfered with, arguing that "[t]he landlord owes his riches to the poverty of the peasants, and the wealth of the capitalist comes from the same source".

In summation, Kropotkin described an anarchist communist economy as functioning like this:

Imagine a society, comprising a few million inhabitants, engaged in agriculture and a great variety of industries—Paris, for example, with the Department of Seine-et-Oise. Suppose that in this society all children learn to work with their hands as well as with their brains. Admit that all adults [...] bind themselves to work 5 hours a day from the age of twenty or twenty-two to forty-five or fifty, and that they follow occupations they have chosen in any one branch of human work considered necessary. Such a society could in return guarantee well-being to all its members; that is to say, a more substantial well-being than that enjoyed to-day by the middle classes. And, moreover, each worker belonging to this society would have at his disposal at least 5 hours a day which he could devote to science, art, and individual needs which do not come under the category of necessities, but will probably do so later on, when man's productivity will have augmented, and those objects will no longer appear luxurious or inaccessible.

— Peter Kropotkin, The Conquest of Bread

Organizationalism vs. insurrectionarism and expansion

At the Berne conference of the International Workingmen's Association in 1876, the Italian anarchist Errico Malatesta argued that the revolution "consists more of deeds than words", and that action was the most effective form of propaganda. In the bulletin of the Jura Federation he declared "the Italian federation believes that the insurrectional fact, destined to affirm socialist principles by deed, is the most efficacious means of propaganda"

As anarcho-communism emerged in the mid-19th century, it had an intense debate with Bakuninist collectivism and, as such, within the anarchist movement itself, over participation in syndicalism and the workers movement as well as on other issues. So in "the theory of the revolution" of anarcho-communism as elaborated by Peter Kropotkin and others, "it is the risen people who are the real agent and not the working class organised in the enterprise (the cells of the capitalist mode of production) and seeking to assert itself as labour power, as a more 'rational' industrial body or social brain (manager) than the employers".

Luigi Galleani influential anarchist advocate of insurrectionary anarchism

Between 1880 and 1890, with the "perspective of an immanent revolution", who was "opposed to the official workers' movement, which was then in the process of formation (general Social Democratisation). They were opposed not only to political (statist) struggles but also to strikes which put forward wage or other claims, or which were organised by trade unions." However, "[w]hile they were not opposed to strikes as such, they were opposed to trade unions and the struggle for the eight-hour day. This anti-reformist tendency was accompanied by an anti-organisational tendency, and its partisans declared themselves in favor of agitation amongst the unemployed for the expropriation of foodstuffs and other articles, for the expropriatory strike and, in some cases, for 'individual recuperation' or acts of terrorism."

Even after Peter Kropotkin and others overcame their initial reservations and decided to enter labor unions, there remained "the anti-syndicalist anarchist-communists, who in France were grouped around Sébastien Faure's Le Libertaire. From 1905 onwards, the Russian counterparts of these anti-syndicalist anarchist-communists become partisans of economic terrorism and illegal 'expropriations'." Illegalism as a practice emerged and within it "[t]he acts of the anarchist bombers and assassins ("propaganda by the deed") and the anarchist burglars ("individual reappropriation") expressed their desperation and their personal, violent rejection of an intolerable society. Moreover, they were clearly meant to be exemplary, invitations to revolt."

Proponents and activists of these tactics among others included Johann Most, Luigi Galleani, Victor Serge, Giuseppe Ciancabilla, and Severino Di Giovanni. The Italian Giuseppe Ciancabilla (1872–1904) wrote in "Against organization" that "we don't want tactical programs, and consequently we don't want organization. Having established the aim, the goal to which we hold, we leave every anarchist free to choose from the means that his sense, his education, his temperament, his fighting spirit suggest to him as best. We don't form fixed programs and we don't form small or great parties. But we come together spontaneously, and not with permanent criteria, according to momentary affinities for a specific purpose, and we constantly change these groups as soon as the purpose for which we had associated ceases to be, and other aims and needs arise and develop in us and push us to seek new collaborators, people who think as we do in the specific circumstance."

By the 1880s, anarcho-communism was already present in the United States as can be seen in the publication of the journal Freedom: A Revolutionary Anarchist-Communist Monthly by Lucy Parsons and Lizzy Holmes. Lucy Parsons debated in her time in the United States with fellow anarcho-communist Emma Goldman over issues of free love and feminism. Another anarcho-communist journal later appeared in the United States called The Firebrand. Most anarchist publications in the United States were in Yiddish, German, or Russian, but Free Society was published in English, permitting the dissemination of anarchist communist thought to English-speaking populations in the United States. Around that time these American anarcho-communist sectors entered in debate with the individualist anarchist group around Benjamin Tucker. In February 1888, Berkman left for the United States from his native Russia. Soon after his arrival in New York City, Berkman became an anarchist through his involvement with groups that had formed to campaign to free the men convicted of the 1886 Haymarket bombing. He as well as Emma Goldman soon came under the influence of Johann Most, the best-known anarchist in the United States; and an advocate of propaganda of the deedattentat, or violence carried out to encourage the masses to revolt. Berkman became a typesetter for Most's newspaper Freiheit.

According to anarchist historian Max Nettlau, the first use of the term libertarian communism was in November 1880, when a French anarchist congress employed it to more clearly identify its doctrines. The French anarchist journalist Sébastien Faure started the weekly paper Le Libertaire (The Libertarian) in 1895.

Methods of organising: platformism vs. synthesism

In Ukraine the anarcho-communist guerrilla leader Nestor Makhno led an independent anarchist army in Ukraine during the Russian Civil War. A commander of the peasant Revolutionary Insurrectionary Army of Ukraine, also known as the Anarchist Black Army, Makhno led a guerrilla campaign opposing both the Bolshevik "Reds" and monarchist "Whites". The revolutionary autonomous movement of which he was a part made various tactical military pacts while fighting various forces of reaction and organizing the Free Territory of Ukraine, an anarchist society, committed to resisting state authority, whether capitalist or Bolshevik. After successfully repelling Austro-Hungarian, White, and Ukrainian Nationalist forces, the Makhnovists militia forces and anarchist communist territories in the Ukraine were eventually crushed by Bolshevik military forces.

In the Mexican Revolution the Mexican Liberal Party was established and during the early 1910s it led a series of military offensives leading to the conquest and occupation of certain towns and districts in Baja California with the leadership of anarcho-communist Ricardo Flores Magón. Kropotkin's The Conquest of Bread, which Flores Magón considered a kind of anarchist bible, served as basis for the short-lived revolutionary communes in Baja California during the Magónista Revolt of 1911. During the Mexican Revolution Emiliano Zapata and his army and allies, including Pancho Villa, fought for agrarian reform in Mexico. Specifically, they wanted to establish communal land rights for Mexico's indigenous population, which had mostly lost its land to the wealthy elite of European descent. Zapata was partly influenced by Ricardo Flores Magón. The influence of Flores Magón on Zapata can be seen in the Zapatistas' Plan de Ayala, but even more noticeably in their slogan (this slogan was never used by Zapata) Tierra y libertad or "land and liberty", the title and maxim of Flores Magón's most famous work. Zapata's introduction to anarchism came via a local schoolteacher, Otilio Montaño Sánchez, later a general in Zapata's army, executed on May 17, 1917, who exposed Zapata to the works of Peter Kropotkin and Flores Magón at the same time as Zapata was observing and beginning to participate in the struggles of the peasants for the land.

A group of exiled Russian anarchists attempted to address and explain the anarchist movement's failures during the Russian Revolution. They wrote the Organizational Platform of the General Union of Anarchists which was written in 1926 by Dielo Truda ("Workers' Cause"). The pamphlet is an analysis of the basic anarchist beliefs, a vision of an anarchist society, and recommendations as to how an anarchist organization should be structured. The four main principles by which an anarchist organization should operate, according to the Platform, are ideological unity, tactical unity, collective action, and federalism. The platform argues that "We have vital need of an organization which, having attracted most of the participants in the anarchist movement, would establish a common tactical and political line for anarchism and thereby serve as a guide for the whole movement".

The Platform attracted strong criticism from many sectors on the anarchist movement of the time including some of the most influential anarchists such as Voline, Errico Malatesta, Luigi Fabbri, Camillo Berneri, Max Nettlau, Alexander Berkman, Emma Goldman and Gregori Maximoff. Malatesta, after initially opposing the Platform, later came to agreement with the Platform confirming that the original difference of opinion was due to linguistic confusion: "I find myself more or less in agreement with their way of conceiving the anarchist organisation (being very far from the authoritarian spirit which the "Platform" seemed to reveal) and I confirm my belief that behind the linguistic differences really lie identical positions."

Sébastien Faure, French anarcho-communist proponent of synthesis anarchism

Two texts were made by the anarchist communists Sébastien Faure and Volin as responses to the Platform, each proposing different models, are the basis for what became known as the organisation of synthesis, or simply synthesism. Voline published in 1924 a paper calling for "the anarchist synthesis" and was also the author of the article in Sébastien Faure's Encyclopedie Anarchiste on the same topic. The main purpose behind the synthesis was that the anarchist movement in most countries was divided into three main tendencies: communist anarchism, anarcho-syndicalism, and individualist anarchism and so such an organization could contain anarchists of this three tendencies very well. Faure in his text "Anarchist synthesis" has the view that "these currents were not contradictory but complementary, each having a role within anarchism: anarcho-syndicalism as the strength of the mass organisations and the best way for the practice of anarchism; libertarian communism as a proposed future society based on the distribution of the fruits of labour according to the needs of each one; anarcho-individualism as a negation of oppression and affirming the individual right to development of the individual, seeking to please them in every way. The Dielo Truda platform in Spain also met with strong criticism. Miguel Jimenez, a founding member of the Iberian Anarchist Federation (FAI), summarized this as follows: too much influence in it of marxism, it erroneously divided and reduced anarchists between individualist anarchists and anarcho-communist sections, and it wanted to unify the anarchist movement along the lines of the anarcho-communists. He saw anarchism as more complex than that, that anarchist tendencies are not mutually exclusive as the platformists saw it and that both individualist and communist views could accommodate anarchosyndicalism. Sébastian Faure had strong contacts in Spain and so his proposal had more impact in Spanish anarchists than the Dielo Truda platform even though individualist anarchist influence in Spain was less strong than it was in France. The main goal there was conciling anarcho-communism with anarcho-syndicalism.

Gruppo Comunista Anarchico di Firenze pointed out that during early twentieth century, the terms libertarian communism and anarchist communism became synonymous within the international anarchist movement as a result of the close connection they had in Spain (see (with libertarian communism) becoming the prevalent term).

Spanish Revolution of 1936

Anarchists during the Spanish Revolution of 1936

The most extensive application of anarcho-communist ideas (i.e. established around the ideas as they exist today and achieving worldwide attention and knowledge in the historical canon) happened in the anarchist territories during the Spanish Revolution.

Flag originally designed and used by the anarcho-syndicalist CNT–FAI confederation of labour unions during the Spanish Civil War representing the anarchist faction of the conflict. Today, the flag is commonly used by anarcho-communists, anarcho-syndicalists libertarian socialists and more generally social anarchists alike.

In Spain, the national anarcho-syndicalist trade union Confederación Nacional del Trabajo initially refused to join a popular front electoral alliance, and abstention by CNT supporters led to a right-wing election victory. In 1936, the CNT changed its policy and anarchist votes helped bring the popular front back to power. Months later, the former ruling class responded with an attempted coup causing the Spanish Civil War (1936–1939). In response to the army rebellion, an anarchist-inspired movement of peasants and workers, supported by armed militias, took control of Barcelona and of large areas of rural Spain where they collectivised the land, but even before the fascist victory in 1939 the anarchists were losing ground in a bitter struggle with the Stalinists, who controlled the distribution of military aid to the Republican cause from the Soviet Union. The events known as the Spanish Revolution was a workers' social revolution that began during the outbreak of the Spanish Civil War in 1936 and resulted in the widespread implementation of anarchist and more broadly libertarian socialist organizational principles throughout various portions of the country for two to three years, primarily Catalonia, Aragon, Andalusia, and parts of the Levante. Much of Spain's economy was put under worker control; in anarchist strongholds like Catalonia, the figure was as high as 75%, but lower in areas with heavy Communist Party of Spain influence, as the Soviet-allied party actively resisted attempts at collectivization enactment. Factories were run through worker committees, agrarian areas became collectivised and run as libertarian communes. Anarchist historian Sam Dolgoff estimated that about eight million people participated directly or at least indirectly in the Spanish Revolution, which he claimed "came closer to realizing the ideal of the free stateless society on a vast scale than any other revolution in history". Stalinist-led troops suppressed the collectives and persecuted both dissident Marxists and anarchists.

An anti-fascist poster from the libertarian socialist factions of Madrid, Spain, reading "The surveillance of the city must be ensured by the Antifascist Popular Guard" as a warning of Nationalist terrorism

Although every sector of the stateless parts of Spain had undergone workers' self-management, collectivisation of agricultural and industrial production, and in parts using money or some degree of private property, a heavy regulation of markets by democratic communities, there were other areas throughout Spain that used no money at all, and followed principles in accordance with "From each according to his ability, to each according to his needs". One such example was the libertarian communist village of Alcora in the Valencian Community, where money was entirely absent, and distribution of properties and services was done based upon needs, not who could afford them. There was no distinction between rich and poor, and everyone held everything in common. Buildings that used to function as shops were made storehouses, where instead of buying and selling, which didn't exist in Alcora during the war, they were centers for distribution, where everyone took freely without paying. Labour was only conducted for enjoyment, with levels of productivity, quality of life, and general prosperity having dramatically risen after the fall of markets. Common ownership of property allowed for each inhabitant of the village to fulfil their needs without lowering themselves for the sake of profit, and each individual living in Alcora found themselves as ungoverned, anarchists free of rulers and private property.

Post-war years

Anarcho-communism entered into internal debates once again over the issue of organization in the post-World War II era. Founded in October 1935 the Anarcho-Communist Federation of Argentina (FACA, Federación Anarco-Comunista Argentina) in 1955 renamed itself as the Argentine Libertarian Federation. The Fédération Anarchiste (FA) was founded in Paris on December 2, 1945, and elected the platformist anarcho-communist George Fontenis as its first secretary the next year. It was composed of a majority of activists from the former FA (which supported Voline's Synthesis) and some members of the former Union Anarchiste, which supported the CNT-FAI support to the Republican government during the Spanish Civil War, as well as some young Resistants. In 1950 a clandestine group formed within the FA called Organisation Pensée Bataille (OPB) led by George Fontenis. The Manifesto of Libertarian Communism was written in 1953 by Georges Fontenis for the Federation Communiste Libertaire of France. It is one of the key texts of the anarchist-communist current known as platformism. The OPB pushed for a move which saw the FA change its name into the Fédération Communiste Libertaire (FCL) after the 1953 Congress in Paris, while an article in Le Libertaire indicated the end of the cooperation with the French Surrealist Group led by André Breton.

The new decision making process was founded on unanimity: each person has a right of veto on the orientations of the federation. The FCL published the same year the Manifeste du communisme libertaire. Several groups quit the FCL in December 1955, disagreeing with the decision to present "revolutionary candidates" to the legislative elections. On August 15–20, 1954, the Ve intercontinental plenum of the CNT took place. A group called Entente anarchiste appeared which was formed of militants who didn't like the new ideological orientation that the OPB was giving the FCL seeing it was authoritarian and almost marxist. The FCL lasted until 1956 just after it participated in state legislative elections with 10 candidates. This move alienated some members of the FCL and thus produced the end of the organization. A group of militants who didn't agree with the FA turning into FCL reorganized a new Federation Anarchiste which was established in December 1953. This included those who formed L'Entente anarchiste who joined the new FA and then dissolved L'Entente. The new base principles of the FA were written by the individualist anarchist Charles-Auguste Bontemps and the non-platformist anarcho-communist Maurice Joyeux which established an organization with a plurality of tendencies and autonomy of groups organized around synthesist principles. According to historian Cédric Guérin, "the unconditional rejection of Marxism became from that moment onwards an identity element of the new Federation Anarchiste" and this was motivated in a big part after the previous conflict with George Fontenis and his OPB.

In Italy, the Italian Anarchist Federation was founded in 1945 in Carrara. It adopted an "Associative Pact" and the "Anarchist Program" of Errico Malatesta. It decided to publish the weekly Umanità Nova retaking the name of the journal published by Errico Malatesta. Inside the FAI, the Anarchist Groups of Proletarian Action (GAAP) was founded, led by Pier Carlo Masini, which "proposed a Libertarian Party with an anarchist theory and practice adapted to the new economic, political and social reality of post-war Italy, with an internationalist outlook and effective presence in the workplaces [...] The GAAP allied themselves with the similar development within the French Anarchist movement" as led by George Fontenis. Another tendency which didn't identify either with the more classical FAI or with the GAAP started to emerge as local groups. These groups emphasized direct action, informal affinity groups and expropriation for financing anarchist activity. From within these groups the influential insurrectionary anarchist Alfredo Maria Bonanno will emerge influenced by the practice of the Spanish exiled anarchist José Lluis Facerías. In the early seventies a platformist tendency emerged within the Italian Anarchist Federation which argued for more strategic coherence and social insertion in the workers movement while rejecting the synthesist "Associative Pact" of Malatesta which the FAI adhered to. These groups started organizing themselves outside the FAI in organizations such as O.R.A. from Liguria which organized a Congress attended by 250 delegates of groups from 60 locations. This movement was influential in the autonomia movements of the seventies. They published Fronte Libertario della lotta di classe in Bologna and Comunismo libertario from Modena. The Federation of Anarchist Communists (Federazione dei Comunisti Anarchici), or FdCA, was established in 1985 in Italy from the fusion of the Organizzazione Rivoluzionaria Anarchica (Revolutionary Anarchist Organisation) and the Unione dei Comunisti Anarchici della Toscana (Tuscan Union of Anarchist Communists).

The International of Anarchist Federations (IAF/IFA) was founded during an international anarchist conference in Carrara in 1968 by the three existing European anarchist federations of France (Fédération Anarchiste), Italy (Federazione Anarchica Italiana) and Spain (Federación Anarquista Ibérica) as well as the Bulgarian federation in French exile. These organizations were also inspired on synthesist principles.

Contemporary times

Libertarian Communism was a socialist journal founded in 1974 and produced in part by members of the Socialist Party of Great Britain. The synthesist Italian Anarchist Federation and the platformist Federation of Anarchist Communists continue existing today in Italy but insurrectionary anarchism continues to be relevant as the recent establishment of the Informal Anarchist Federation shows.

In the 1970s, the French Fédération Anarchiste evolved into a joining of the principles of both synthesis anarchism and platformism but later the platformist organizations Libertarian Communist Organization (France) in 1976 and Alternative libertaire in 1991 appeared with this last one existing until today alongside the synthesist Fédération Anarchiste. In recent times platformist organisations founded the now-defunct International Libertarian Solidarity network and its successor, the Anarkismo network; which is run collaboratively by roughly 30 platformist organisations around the world.

On the other hand, contemporary insurrectionary anarchism inherits the views and tactics of anti-organizational anarcho-communism and illegalism. The Informal Anarchist Federation (not to be confused with the synthesist Italian Anarchist Federation also FAI) is an Italian insurrectionary anarchist organization. It has been described by Italian intelligence sources as a "horizontal" structure of various anarchist terrorist groups, united in their beliefs in revolutionary armed action. In 2003, the group claimed responsibility for a bomb campaign targeting several European Union institutions.

Currently, alongside the previously mentioned federations, the International of Anarchist Federations includes the Argentine Libertarian Federation, the Anarchist Federation of Belarus, the Federation of Anarchists in Bulgaria, the Czech-Slovak Anarchist Federation, the Federation of German speaking Anarchists in Germany and Switzerland, and the Anarchist Federation in the United Kingdom.

Economic theory

The abolition of money, prices, and wage labor is central to anarchist communism. With distribution of wealth being based on self-determined needs, people would be free to engage in whatever activities they found most fulfilling and would no longer have to engage in work for which they have neither the temperament nor the aptitude.

Anarcho-communists argue that there is no valid way of measuring the value of any one person's economic contributions because all wealth is a common product of current and preceding generations. For instance, one could not measure the value of a factory worker's daily production without taking into account how transportation, food, water, shelter, relaxation, machine efficiency, emotional mood etc. contributed to their production. To truly give numerical economic value to anything, an overwhelming amount of externalities and contributing factors would need to be taken into account – especially current or past labor contributing to the ability to utilize future labor. As Kropotkin put it: "No distinction can be drawn between the work of each man. Measuring the work by its results leads us to absurdity; dividing and measuring them by hours spent on the work also leads us to absurdity. One thing remains: put the needs above the works, and first of all recognize the right to live, and later on, to the comforts of life, for all those who take their share in production.."

The Conquest of Bread by Peter Kropotkin, influential work which presents the economic vision of anarcho-communism

Communist anarchism shares many traits with collectivist anarchism, but the two are distinct. Collectivist anarchism believes in collective ownership while communist anarchism negates the entire concept of ownership in favor of the concept of usage. Crucially, the abstract relationship of "landlord" and "tenant" would no longer exist, as such titles are held to occur under conditional legal coercion and are not absolutely necessary to occupy buildings or spaces (intellectual property rights would also cease, since they are a form of private property). In addition to believing rent and other fees are exploitative, anarcho-communists feel these are arbitrary pressures inducing people to carry out unrelated functions. For example, they question why one should have to work for 'X hours' a day to merely live somewhere. So instead of working conditionally for the sake of the wage earned, they believe in working directly for the objective at hand.

Philosophical debates

Motivation

Anarchist communists reject the claim: 'wage labor is necessary because people are lazy and selfish by "human nature"'. They often point out that even the so-called "idle rich" sometimes find useful things to do despite having all their needs satisfied by the labour of others. Anarcho-communists generally do not agree with the belief in a pre-set "human nature", arguing that human culture and behavior is very largely determined by socialization and the mode of production. Many anarchist communists, like Peter Kropotkin, also believe that the human evolutionary tendency is for humans to cooperate with each other for mutual benefit and survival instead of existing as lone competitors, a position that Kropotkin argued for at length.

While anarchist communists such as Peter Kropotkin and Murray Bookchin believed that the members of such a society would voluntarily perform all necessary labour because they would recognize the benefits of communal enterprise and mutual aid, other anarchist communists such as Nestor Makhno and Ricardo Flores Magón argue that all those able to work in an anarchist communist society should be obligated to do so, excepting groups like children, the elderly, the sick, or the infirm Kropotkin did not think laziness or sabotage would be a major problem in an authentically anarchist-communist society, but he did agree that a freely associated anarchist commune could, and probably should, deliberately disassociate from those not fulfilling their communal agreement to do their share of work. Peter Gelderloos, based on the Kibbutz, argues that motivation in a moneyless society would be found in the satisfaction of work, concern for community, competition for prestige and praise from other community members.

Freedom, work and leisure

Anarchist communists support communism as a means for ensuring the greatest freedom and well-being for everyone, rather than only the wealthy and powerful. In this sense, anarchist communism is a profoundly egalitarian philosophy.

Anarchist communism as an anarchist philosophy is against hierarchy in all its forms. Anarchist communists do not think that anyone has the right to be anyone else's master, or 'boss' as this is a concept of capitalism and the state and implies authority over the individual. Some contemporary anarchist communists and advocates of post-left anarchy, such as Bob Black, reject the concept of work altogether in favor of turning necessary subsistence tasks into voluntary free play.

Kropotkin said that the main authoritarian mistakes in communist experiments of the past were their being based on "religious enthusiasm" and the desire to live "as a family" where the individual had to "submit to the dictates of a punctilious morality". For him anarcho-communism should be based on the right of free association and disassociation for individuals and groups and on significantly lowering the number of hours each individual dedicates to necessary labor. He says that "to recognise a variety of occupations as the basis of all progress and to organise in such a way that man may be absolutely free during his leisure time, whilst he may also vary his work, a change for which his early education and instruction will have prepared him—this can easily be put in practice in a Communist society—this, again, means the emancipation of the individual, who will find doors open in every direction for his complete development".

Individualism and collectivism

Some anarcho-communists and collectivist anarchists as well reject individualism and collectivism as illusory concepts. They argue that individuals sacrificing themselves for the "greater", or being ruled by the "community" or "society", is not possible because society is composed of individuals rather than being a cohesive unit separate from the individual and argue that collective control over the individual is tyrannical and antithetical to anarchism. Others such as Lucien van der Walt and Michael Schmidt argue that "[t]he anarchists did not [...] identify freedom with the right of everybody to do exactly what one pleased but with a social order in which collective effort and responsibilities—that is to say, obligations—would provide the material basis and social nexus in which individual freedom could exist." They argued that "genuine freedom and individuality could only exist in a free society" and that in contrast to "misanthropic bourgeois individualism" anarchism was based in "a deep love of freedom, understood as a social product, a deep respect for human rights, a profound celebration of humankind and its potential and a commitment to a form of society where a 'true individuality' was irrevocably linked to 'the highest communist socieability'" Egoist anarchist philosophical positions are important in anarcho-communist insurrectionary anarchism. In the early 20th century, the Italian individualist anarchist Renzo Novatore advocated both revolution and anarcho-communism when he said "revolution is the fire of our will and a need of our solitary minds; it is an obligation of the libertarian aristocracy. To create new ethical values. To create new aesthetic values. To communalize material wealth. To individualize spiritual wealth." From Stirnerist positions, he also disrespected private property when he said that "[o]nly ethical and spiritual wealth" was "invulnerable. This is the true property of individuals. The rest no! The rest is vulnerable! And all that is vulnerable will be violated!" This can also be seen in the contemporary writings of insurrectionary anarchism as can be seen in the work of Wolfi Landstreicher, Alfredo Bonanno, and others. After analysing insurrectionary anarcho-communist Luigi Galleani's view on anarcho-communism, post-left anarcho-communist Bob Black, went as far as saying that "communism is the final fulfillment of individualism [...] The apparent contradiction between individualism and communism rests on a misunderstanding of both [...] Subjectivity is also objective: the individual really is subjective. It is nonsense to speak of 'emphatically prioritizing the social over the individual,' [...] You may as well speak of prioritizing the chicken over the egg. Anarchy is a 'method of individualization.' It aims to combine the greatest individual development with the greatest communal unity."

On the article by Max Baginski called "Stirner: The Ego and His Own", published in the American anarchist magazine Mother Earth, there is the following affirmation: "Modern Communists are more individualistic than Stirner. To them, not merely religion, morality, family and State are spooks, but property also is no more than a spook, in whose name the individual is enslaved—and how enslaved! The individuality is nowadays held in far stronger bondage by property, than by the combined power of State, religion and morality [...] The prime condition is that the individual should not be forced to humiliate and lower himself for the sake of property and subsistence. Communism thus creates a basis for the liberty and Eigenheit of the individual. I am a Communist because I am an Individualist. Fully as heartily the Communists concur with Stirner when he puts the word take in place of demand—that leads to the dissolution of private property, to expropriation. Individualism and Communism go hand in hand."

Property

Alexander Berkman advocated for profit to be replaced with communities of common property, where all members of a group shared possessions.

Anarchist communists counter the capitalist conception that communal property can only be maintained by force and that such a position is neither fixed in nature nor unchangeable in practice, citing numerous examples of communal behavior occurring naturally even within capitalist systems. Anarchist communists call for the abolition of private property while maintaining respect for personal property. As such the prominent anarcho-communist Alexander Berkman maintained that "The revolution abolishes private ownership of the means of production and distribution, and with it goes capitalistic business. Personal possession remains only in the things you use. Thus, your watch is your own, but the watch factory belongs to the people. Land, machinery, and all other public utilities will be collective property, neither to be bought nor sold. Actual use will be considered the only title-not to ownership but to possession. The organization of the coal miners, for example, will be in charge of the coal mines, not as owners but as the operating agency. Similarly will the railroad brotherhoods run the railroads, and so on. Collective possession, cooperatively managed in the interests of the community, will take the place of personal ownership privately conducted for profit."

An important difference between anarchist communism and Marxist communism is to whom the product of the worker's labor belongs. Both ideologies believe that the product of labor does not belong to the capitalist due to it being produced by the worker and not the employer, however, there are slight differences between the opinions taken by anarchist communist Peter Kropotkin and Karl Marx. Marx stated that the product of the worker's labor belongs to the worker due to it being produced by the worker. In contrast, Kropotkin believed that the product of the worker's labor belongs to the community as a whole. Kropotkin argued that this was the case because the worker relied on the previous work of untold millions to even begin his particular form of labor, and therefore, his work should belong to the community, since he benefited from the community. This went on to providing the understanding, all belongs to all, because every virtue of the present was only made possible due to other peoples' efforts of the past.

Communes as an economic democracy

Anarcho-communism has been critical of a simple call for worker's ownership of workplaces and their administration as cooperatives. While not at odds with syndicalism as a tactic, it opposes the vision of anarcho-syndicalism as a theory, which sees a post-capitalist economy being made up of federations of industrial syndicates.

Anarcho-communism proposes that the future society be organised territorially through free communes (localities) instead of industrially through workers' unions (syndicates). Each commune is perceived as an integrated political-economic unit, removing the distinction between work and community, as well as existing as part of a wider communal-confederation made up of other such autonomous communes, linked together via voluntary contractual agreements. This is seen as overcoming the economic-centrism of more "workerist" forms of socialism which focus on the workplace alone as a site of struggle.

Murray Bookchin has put it this way:

But what of the syndicalist ideal of "collectivized" self-managed enterprises that are coordinated by like occupations on a national level and coordinated geographically by "collectives" on a local level? [...] Here, the traditional socialist criticism of this syndicalist form of economic management is not without its point: the corporate or private capitalist, "worker-controlled" or not—ironically, a technique in the repertoire of industrial management that is coming very much into vogue today as "workplace democracy" and "employee ownership" and constitutes no threat whatever to private property and capitalism [...] In any case, "economic democracy" has not simply meant "workplace democracy" and "employee ownership."

Many workers, in fact, would like to get away from their factories if they could and find more creative artisanal types of work, not simply "participate" in "planning" their own misery. What "economic democracy" meant in its profoundest sense was free, "democratic" access to the means of life, the counterpart of political democracy, that is, the guarantee of freedom from material want. It is a dirty bourgeois trick, in which many radicals unknowingly participate, that "economic democracy" has been re-interpreted as "employee ownership" and "workplace democracy" and has come to mean workers' "participation" in profit sharing and industrial management rather than freedom from the tyranny of the factory, rationalized labor, and "planned production," which is usually exploitative production with the complicity of the workers.

Bookchin further argued:

Whereas the syndicalist alternative re-privatizes the economy into "self-managed" collectives and opens the way to their degeneration into traditional forms of private property—whether "collectively" owned or not—libertarian municipalism politicizes the economy and dissolves it into the civic domain. Neither factory or land appear as separate interests within the communal collective. Nor can workers, farmers, technicians, engineers, professionals, and the like perpetuate their vocational identities as separate interests that exist apart from the citizen body in face-to-face assemblies. "Property" is integrated into the commune as a material constituent of its libertarian institutional framework, indeed as a part of a larger whole that is controlled by the citizen body in assembly as citizens—not as vocationally oriented interest groups.

The term communism in anarcho-communism should be taken to refer to a polity of communes as well as an economy of the commons.

Revolution and transition

UCL, anarchist communist organization protest in France, on October 16th during the COVID-19 pandemic

According to platformist anarcho-communist Wayne Price:

Today's proposals for Parecon, in which workers are rewarded for the intensity and duration of their labor in a cooperative economy, would fit into Bakunin's or Marx's concept of a transitory, beginning, phase, of a free society. [...] Kropotkin rejected the two-phase approach of the Marxists and the anarchist-collectivists. Instead he proposed that a revolutionary society should "transform itself immediately into a communist society, that is, should go immediately into what Marx had regarded as the "more advanced", completed, phase of communism. Kropotkin and those who agreed with him called themselves "anarchist-communists" (or "communist anarchists"), although they continued to regard themselves as a part of the broader socialist movement.

Student anarchist riot against the IMF

Leninists believe that without a transitional period of state control (their interpretation of the dictatorship of the proletariat), it would be impossible for any revolution to maintain the momentum or cohesion to defend the new society against external and internal threats. Friedrich Engels noted: "Without a previous social revolution the abolition of the state is nonsense; the abolition of capital is in itself the social revolution and involves a change in the whole method of production." Alternatively, such quotations have been interpreted by anarcho-communists supportive of Marx and Engels to suggest the abolition of capitalism and the state simultaneously, not the creation of a new state. Anarchists reject the Marxist–Leninist model of the "dictatorship of the proletariat," arguing that any revolutionary minority taking over state power would be just as authoritarian as the ruling class in capitalism to defend the new state, and would eventually constitute itself as a new ruling class. As an extension of this, anarcho-communists counter-argue that decentralized, stateless collective federations are sufficient to give both power to workers and preserve personal freedom and point to the fact that no socialist state has ever showed signs of "withering away". The Spanish Revolution is cited as an example of successful anarchist military mobilization, albeit one crushed by superior forces.

Free association of communes as opposed to the nation-state

Anarcho-communism calls for a decentralized confederal form in relationships of mutual aid and free association between communes as an alternative to the centralism of the nation-state. Peter Kropotkin thus suggested:

Representative government has accomplished its historical mission; it has given a mortal blow to court-rule; and by its debates it has awakened public interest in public questions. But to see in it the government of the future socialist society is to commit a gross error. Each economic phase of life implies its own political phase; and it is impossible to touch the very basis of the present economic life—private property—without a corresponding change in the very basis of the political organization. Life already shows in which direction the change will be made. Not in increasing the powers of the State, but in resorting to free organization and free federation in all those branches which are now considered as attributes of the State.

Kropotkin further argued:

[N]o community can hope to achieve economic autarchy, nor should it try to do so unless it wishes to become self-enclosed and parochial, not only "self-sufficient". Hence the confederation of communes "the Commune of communes" is reworked economically as well as politically into a shared universe of publicly managed resources. The management of the economy, precisely because it is a public activity, does not degenerate into privatized interactions between enterprises; rather it develops into confederalized interactions between municipalities. That is to say, the very elements of societal interaction are expanded from real or potential privatized components to institutionally real public components. Confederation becomes a public project by definition, not only because of shared needs and resources. If there is any way to avoid the emergence of the city-state, not to speak of self-serving bourgeois "cooperatives," it is through a municipalization of political life that is so complete that politics embraces not only what we call the public sphere but material means of life as well.

Example societies through history

Early examples

There have been several attempts, both successful and unsuccessful, at creating other anarchist-communist societies throughout much of the world. Anarchist-communists and some green anarchists (especially anarcho-primitivists) argue that hunter-gatherer tribes, like families, were early forms of anarchist-communism due to their egalitarian nature.

Early Christian communities have also been described as having anarcho-communist characteristics. Frank Seaver Billings described "Jesusism" as a combination of anarchism and communism. Examples of later Christian egalitarian communities include the Diggers.

Gift economies and commons-based organising

Watercolor by James G. Swan depicting the Klallam people of chief Chetzemoka at Port Townsend, with one of Chetzemoka's wives distributing potlatch

In anthropology and the social sciences, a gift economy (or gift culture) is a mode of exchange where valuable goods and services are regularly given without any explicit agreement for immediate or future rewards (i.e. no formal quid pro quo exists). Ideally, voluntary and recurring gift exchange circulates and redistributes wealth throughout a community, and serves to build societal ties and obligations. In contrast to a barter economy or a market economy, social norms and custom governs gift exchange, rather than an explicit exchange of goods or services for money or some other commodity.

Traditional societies dominated by gift exchange were small in scale and geographically remote from each other. As states formed to regulate trade and commerce within their boundaries, market exchange came to dominate. Nonetheless, the practice of gift exchange continues to play an important role in modern society. One prominent example is scientific research, which can be described as a gift economy. Contrary to popular conception, there is no evidence that societies relied primarily on barter before using money for trade. Instead, non-monetary societies operated largely along the principles of gift economics, and in more complex economies, on debt. When barter did in fact occur, it was usually between either complete strangers or would-be enemies.

The expansion of the Internet has witnessed a resurgence of the gift economy, especially in the technology sector. Engineers, scientists and software developers create open-source software projects. The Linux kernel and the GNU operating system are prototypical examples for the gift economy's prominence in the technology sector and its active role in instating the use of permissive free software and copyleft licenses, which allow free reuse of software and knowledge. Other examples include file-sharing, the commons and open access. Anarchist scholar Uri Gordon has argued:

The collaborative development of free software like the Linux operating system and applications such as OpenOffice clearly approximate an informational anarchist communism. Moreover, for anarchists it is precisely the logic of expropriation and electronic piracy that enables a radical political extension of the cultural ideals of the free manipulation, circulation and use of information associated with the "hacker ethic" (Himanen 2001). The space of illegality created by P2P (peer-to-peer) file-sharing opens up the possibility, not only of the open circulation of freely-given information and software as it is on the Internet today, but also of conscious copyright violation. The Internet, then, enables not only communist relations around information, but also the militant contamination and erosion of non-communist regimes of knowledge—a technological "weapon" to equalise access to information, eating away at intellectual property rights by rendering them unenforceable.

The interest in such economic forms goes back to Peter Kropotkin, who saw in the hunter-gatherer tribes he had visited the paradigm of "mutual aid". anarchist anthropologist David Graeber in his 2011 book Debt: The First 5000 Years argues that with the advent of the great Axial Age civilizations, the nexus between coinage and the calculability of economic values was concomitant with the disrupt of what Graeber calls "human economies," as found among the Iroquois, Celts, Inuit, Tiv, Nuer, and the Malagasy people of Madagascar among other groups which, according to Graeber, held a radically different conception of debt and social relations, based on the radical incalculability of human life and the constant creation and recreation of social bonds through gifts, marriages and general sociability. The author postulates the growth of a "military-coinage-slave complex" around this time, through which mercenary armies looted cities and human beings were cut from their social context to work as slaves in Greece, Rome and elsewhere in the Eurasian continent. The extreme violence of the period marked by the rise of great empires in China, India and the Mediterranean was, in this way, connected with the advent of large-scale slavery and the use of coins to pay soldiers, together with the obligation enforced by the State for its subjects to pay its taxes in currency. This was also the same time that the great religions spread out and the general questions of philosophical enquiry emerged on world history—many of those directly related, as in Plato's Republic, with the nature of debt and its relation to ethics.

Korean Anarchist Movement

The Korean People's Association in Manchuria, a Korean anarchist society that existed without markets, structured on mutual aid and gift economics

The Korean Anarchist Movement in Korea led by Kim Chwa-chin briefly brought anarcho-communism to Korea. The success was short-lived and much less widespread than the anarchism in Spain. The Korean People's Association in Manchuria had established a stateless, classless society where all means of production were run and operated by the workers, and where all possessions were held in common by the community.

Inside Utrecht Giveaway shop the banner reads: "The earth has enough for everyone's need, but not for everyone's greed. Take no more than you could use yourself"

Urban communities

Trumbullplex, as an example of an anarchist community, operates to serve the common good through sheltering residents within a neighbourhood of Detroit, Michigan. This allows individuals who've previously gone into debt by means of rent to escape their economic burdens and join a democratic commune. The commune has served as a hangout for young members of the locality, alongside a place intended for teamwork and cooperative decision making. This is often accompanied by music of the punk rock genre and frequent parties and celebrations thrown by Trumbullplex members. The commune has existed since 1993. Its current ideology, the same as its founding ideology, was to establish a settlement based on principles of mutual aid and the absence of hierarchy.

Give-away shops

Give-away shops, free shops, or free stores, are stores where all goods are free. They are similar to charity shops, with mostly second-hand items—only everything is available at no cost. Whether it is a book, a piece of furniture, a garment or a household item, it is all freely given away, although some operate a one-in, one-out–type policy (swap shops). The free store is a form of constructive direct action that provides a shopping alternative to a monetary framework, allowing people to exchange goods and services outside of a money-based economy. The anarchist 1960s countercultural group The Diggers opened free stores which simply gave away their stock, provided free food, distributed free drugs, gave away money, organized free music concerts, and performed works of political art. The Diggers took their name from the original English Diggers led by Gerrard Winstanley and sought to create a mini-society free of money and capitalism. Although free stores have not been uncommon in the United States since the 1960s, the freegan movement has inspired the establishment of more free stores. Today the idea is kept alive by the new generations of social centres, anarchists and environmentalists who view the idea as an intriguing way to raise awareness about consumer culture and to promote the reuse of commodities.

Atherosclerosis

From Wikipedia, the free encyclopedia
Other namesArteriosclerotic vascular disease (ASVD)
Endo dysfunction Athero.PNG
The progression of atherosclerosis (narrowing exaggerated)
SpecialtyCardiology, angiology
SymptomsNone
ComplicationsCoronary artery disease, stroke, peripheral artery disease, kidney problems
Usual onsetYouth (worsens with age)
CausesUnknown
Risk factorsHigh blood pressure, diabetes, smoking, obesity, family history, unhealthy diet
PreventionHealthy diet, exercise, not smoking, maintaining a normal weight
MedicationStatins, blood pressure medication, aspirin
Frequency≈100% (>65 years old)

Atherosclerosis is a pattern of the disease arteriosclerosis in which the wall of the artery develops abnormalities, called lesions. These lesions may lead to narrowing due to the buildup of atheromatous plaque. Initially, there are generally no symptoms. When severe, it can result in coronary artery disease, stroke, peripheral artery disease, or kidney problems, depending on which arteries are affected. Symptoms, if they occur, generally do not begin until middle age.

The exact cause is not known. Risk factors include abnormal cholesterol levels, elevated levels of inflammatory markers, high blood pressure, diabetes, smoking, obesity, family history, and an unhealthy diet. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. The narrowing of arteries limits the flow of oxygen-rich blood to parts of the body. Diagnosis is based upon a physical exam, electrocardiogram, and exercise stress test, among others.

Prevention is generally by eating a healthy diet, exercising, not smoking, and maintaining a normal weight. Treatment of established disease may include medications to lower cholesterol such as statins, blood pressure medication, or medications that decrease clotting, such as aspirin. A number of procedures may also be carried out such as percutaneous coronary intervention, coronary artery bypass graft, or carotid endarterectomy.

Atherosclerosis generally starts when a person is young and worsens with age. Almost all people are affected to some degree by the age of 65. It is the number one cause of death and disability in the developed world. Though it was first described in 1575, there is evidence that the condition occurred in people more than 5,000 years ago.

Signs and symptoms

Atherosclerosis is asymptomatic for decades because the arteries enlarge at all plaque locations, thus there is no effect on blood flow. Even most plaque ruptures do not produce symptoms until enough narrowing or closure of an artery, due to clots, occurs. Signs and symptoms only occur after severe narrowing or closure impedes blood flow to different organs enough to induce symptoms. Most of the time, patients realize that they have the disease only when they experience other cardiovascular disorders such as stroke or heart attack. These symptoms, however, still vary depending on which artery or organ is affected.

Abnormalities associated with atherosclerosis begin in childhood. Fibrous and gelatinous lesions have been observed in the coronary arteries of children aged 6–10. Fatty streaks have been observed in the coronary arteries of juveniles aged 11–15, though they appear at a much younger age within the aorta.

Clinically, given enlargement of the arteries for decades, symptomatic atherosclerosis is typically associated with men in their 40s and women in their 50s to 60s. Sub-clinically, the disease begins to appear in childhood and rarely is already present at birth. Noticeable signs can begin developing at puberty. Though symptoms are rarely exhibited in children, early screening of children for cardiovascular diseases could be beneficial to both the child and his/her relatives. While coronary artery disease is more prevalent in men than women, atherosclerosis of the cerebral arteries and strokes equally affect both sexes.

Marked narrowing in the coronary arteries, which are responsible for bringing oxygenated blood to the heart, can produce symptoms such as the chest pain of angina and shortness of breath, sweating, nausea, dizziness or light-headedness, breathlessness or palpitations. Abnormal heart rhythms called arrhythmias—the heart beating either too slowly or too quickly—are another consequence of ischemia.

Carotid arteries supply blood to the brain and neck. Marked narrowing of the carotid arteries can present with symptoms such as: a feeling of weakness; being unable to think straight; difficulty speaking; dizziness; difficulty in walking or standing up straight; blurred vision; numbness of the face, arms and legs; severe headache; and loss of consciousness. These symptoms are also related to stroke (the death of brain cells). Stroke is caused by marked narrowing or closure of arteries going to the brain; lack of adequate blood supply leads to the death of the cells of the affected tissue.

Peripheral arteries, which supply blood to the legs, arms and pelvis, also experience marked narrowing due to plaque rupture and clots. Symptoms of the narrowing are numbness within the arms or legs, as well as pain. Another significant location for plaque formation is the renal arteries, which supply blood to the kidneys. Plaque occurrence and accumulation lead to decreased kidney blood flow and chronic kidney disease, which, like in all other areas, is typically asymptomatic until late stages.

According to United States data for 2004, in about 66% of men and 47% of women, the first symptom of atherosclerotic cardiovascular disease is a heart attack or sudden cardiac death (death within one hour of onset of the symptom). Cardiac stress testing, traditionally the most commonly performed non-invasive testing method for blood flow limitations, in general, detects only lumen narrowing of ≈75% or greater, although some physicians claim that nuclear stress methods can detect as little as 50%.

Case studies have included autopsies of U.S. soldiers killed in World War II and the Korean War. A much-cited report involved the autopsies of 300 U.S. soldiers killed in Korea. Although the average age of the men was 22.1 years, 77.3 percent had "gross evidence of coronary arteriosclerosis". Other studies done of soldiers in the Vietnam War showed similar results, although often worse than the ones from the earlier wars. Theories include high rates of tobacco use and (in the case of the Vietnam soldiers) the advent of processed foods after World War II.

Risk factors

Atherosclerosis and lipoproteins
 

The atherosclerotic process is not well understood. Atherosclerosis is associated with inflammatory processes in the endothelial cells of the vessel wall associated with retained low-density lipoprotein (LDL) particles. This retention may be a cause, an effect, or both, of the underlying inflammatory process.

The presence of the plaque induces the muscle cells of the blood vessel to stretch, compensating for the additional bulk, and the endothelial lining thickens, increasing the separation between the plaque and lumen. This somewhat offsets the narrowing caused by the growth of the plaque, but it causes the wall to stiffen and become less compliant to stretching with each heartbeat.

Modifiable

Nonmodifiable

Lesser or uncertain

Dietary

The relation between dietary fat and atherosclerosis is controversial. The USDA, in its food pyramid, promotes a diet of about 64% carbohydrates from total calories. The American Heart Association, the American Diabetes Association and the National Cholesterol Education Program make similar recommendations. In contrast, Prof Walter Willett (Harvard School of Public Health, PI of the second Nurses' Health Study) recommends much higher levels of fat, especially of monounsaturated and polyunsaturated fat. These dietary recommendations reach a consensus, though, against consumption of trans fats.

The role of eating oxidized fats (rancid fats) in humans is not clear. Rabbits fed rancid fats develop atherosclerosis faster. Rats fed DHA-containing oils experienced marked disruptions to their antioxidant systems, and accumulated significant amounts of phospholipid hydroperoxide in their blood, livers and kidneys.

Rabbits fed atherogenic diets containing various oils were found to undergo the greatest amount of oxidative susceptibility of LDL via polyunsaturated oils. In another study, rabbits fed heated soybean oil "grossly induced atherosclerosis and marked liver damage were histologically and clinically demonstrated." However, Fred Kummerow claims that it is not dietary cholesterol, but oxysterols, or oxidized cholesterols, from fried foods and smoking, that are the culprit.

Rancid fats and oils taste very unpleasant in even small amounts, so people avoid eating them. It is very difficult to measure or estimate the actual human consumption of these substances. Highly unsaturated omega-3 rich oils such as fish oil, when being sold in pill form, can hide the taste of oxidized or rancid fat that might be present. In the US, the health food industry's dietary supplements are self-regulated and outside of FDA regulations. To properly protect unsaturated fats from oxidation, it is best to keep them cool and in oxygen-free environments.

Pathophysiology

Atherogenesis is the developmental process of atheromatous plaques. It is characterized by a remodeling of arteries leading to subendothelial accumulation of fatty substances called plaques. The buildup of an atheromatous plaque is a slow process, developed over a period of several years through a complex series of cellular events occurring within the arterial wall and in response to a variety of local vascular circulating factors. One recent hypothesis suggests that, for unknown reasons, leukocytes, such as monocytes or basophils, begin to attack the endothelium of the artery lumen in cardiac muscle. The ensuing inflammation leads to the formation of atheromatous plaques in the arterial tunica intima, a region of the vessel wall located between the endothelium and the tunica media. The bulk of these lesions is made of excess fat, collagen, and elastin. At first, as the plaques grow, only wall thickening occurs without any narrowing. Stenosis is a late event, which may never occur and is often the result of repeated plaque rupture and healing responses, not just the atherosclerotic process by itself.

Cellular

Micrograph of an artery that supplies the heart showing significant atherosclerosis and marked luminal narrowing. Tissue has been stained using Masson's trichrome.

Early atherogenesis is characterized by the adherence of blood circulating monocytes (a type of white blood cell) to the vascular bed lining, the endothelium, then by their migration to the sub-endothelial space, and further activation into monocyte-derived macrophages. The primary documented driver of this process is oxidized lipoprotein particles within the wall, beneath the endothelial cells, though upper normal or elevated concentrations of blood glucose also plays a major role and not all factors are fully understood. Fatty streaks may appear and disappear.

Low-density lipoprotein (LDL) particles in blood plasma invade the endothelium and become oxidized, creating risk of cardiovascular disease. A complex set of biochemical reactions regulates the oxidation of LDL, involving enzymes (such as Lp-LpA2) and free radicals in the endothelium.

Initial damage to the endothelium results in an inflammatory response. Monocytes enter the artery wall from the bloodstream, with platelets adhering to the area of insult. This may be promoted by redox signaling induction of factors such as VCAM-1, which recruit circulating monocytes, and M-CSF, which is selectively required for the differentiation of monocytes to macrophages. The monocytes differentiate into macrophages, which proliferate locally, ingest oxidized LDL, slowly turning into large "foam cells" – so-called because of their changed appearance resulting from the numerous internal cytoplasmic vesicles and resulting high lipid content. Under the microscope, the lesion now appears as a fatty streak. Foam cells eventually die and further propagate the inflammatory process.

In addition to these cellular activities, there is also smooth muscle proliferation and migration from the tunica media into the intima in response to cytokines secreted by damaged endothelial cells. This causes the formation of a fibrous capsule covering the fatty streak. Intact endothelium can prevent this smooth muscle proliferation by releasing nitric oxide.

Calcification and lipids

Calcification forms among vascular smooth muscle cells of the surrounding muscular layer, specifically in the muscle cells adjacent to atheromas and on the surface of atheroma plaques and tissue. In time, as cells die, this leads to extracellular calcium deposits between the muscular wall and outer portion of the atheromatous plaques. With the atheromatous plaque interfering with the regulation of the calcium deposition, it accumulates and crystallizes. A similar form of intramural calcification, presenting the picture of an early phase of arteriosclerosis, appears to be induced by many drugs that have an antiproliferative mechanism of action (Rainer Liedtke 2008).

Cholesterol is delivered into the vessel wall by cholesterol-containing low-density lipoprotein (LDL) particles. To attract and stimulate macrophages, the cholesterol must be released from the LDL particles and oxidized, a key step in the ongoing inflammatory process. The process is worsened if it is insufficient high-density lipoprotein (HDL), the lipoprotein particle that removes cholesterol from tissues and carries it back to the liver.

The foam cells and platelets encourage the migration and proliferation of smooth muscle cells, which in turn ingest lipids, become replaced by collagen, and transform into foam cells themselves. A protective fibrous cap normally forms between the fatty deposits and the artery lining (the intima).

These capped fatty deposits (now called 'atheromas') produce enzymes that cause the artery to enlarge over time. As long as the artery enlarges sufficiently to compensate for the extra thickness of the atheroma, then no narrowing ("stenosis") of the opening ("lumen") occurs. The artery becomes expanded with an egg-shaped cross-section, still with a circular opening. If the enlargement is beyond proportion to the atheroma thickness, then an aneurysm is created.

Visible features

Severe atherosclerosis of the aorta. Autopsy specimen.

Although arteries are not typically studied microscopically, two plaque types can be distinguished:

  1. The fibro-lipid (fibro-fatty) plaque is characterized by an accumulation of lipid-laden cells underneath the intima of the arteries, typically without narrowing the lumen due to compensatory expansion of the bounding muscular layer of the artery wall. Beneath the endothelium, there is a "fibrous cap" covering the atheromatous "core" of the plaque. The core consists of lipid-laden cells (macrophages and smooth muscle cells) with elevated tissue cholesterol and cholesterol ester content, fibrin, proteoglycans, collagen, elastin, and cellular debris. In advanced plaques, the central core of the plaque usually contains extracellular cholesterol deposits (released from dead cells), which form areas of cholesterol crystals with empty, needle-like clefts. At the periphery of the plaque are younger "foamy" cells and capillaries. These plaques usually produce the most damage to the individual when they rupture. Cholesterol crystals may also play a role.
  2. The fibrous plaque is also localized under the intima, within the wall of the artery resulting in thickening and expansion of the wall and, sometimes, spotty localized narrowing of the lumen with some atrophy of the muscular layer. The fibrous plaque contains collagen fibers (eosinophilic), precipitates of calcium (hematoxylinophilic), and, rarely, lipid-laden cells.

In effect, the muscular portion of the artery wall forms small aneurysms just large enough to hold the atheroma that are present. The muscular portion of artery walls usually remains strong, even after they have remodeled to compensate for the atheromatous plaques. However, atheromas within the vessel wall are soft and fragile with little elasticity. Arteries constantly expand and contract with each heartbeat, i.e., the pulse. In addition, the calcification deposits between the outer portion of the atheroma and the muscular wall, as they progress, lead to a loss of elasticity and stiffening of the artery as a whole.

The calcification deposits, after they have become sufficiently advanced, are partially visible on coronary artery computed tomography or electron beam tomography (EBT) as rings of increased radiographic density, forming halos around the outer edges of the atheromatous plaques, within the artery wall. On CT, >130 units on the Hounsfield scale (some argue for 90 units) has been the radiographic density usually accepted as clearly representing tissue calcification within arteries. These deposits demonstrate unequivocal evidence of the disease, relatively advanced, even though the lumen of the artery is often still normal by angiography.

Rupture and stenosis

Progression of atherosclerosis to late complications.

Although the disease process tends to be slowly progressive over decades, it usually remains asymptomatic until an atheroma ulcerates, which leads to immediate blood clotting at the site of the atheroma ulcer. This triggers a cascade of events that leads to clot enlargement, which may quickly obstruct the flow of blood. A complete blockage leads to ischemia of the myocardial (heart) muscle and damage. This process is the myocardial infarction or "heart attack".

If the heart attack is not fatal, fibrous organization of the clot within the lumen ensues, covering the rupture but also producing stenosis or closure of the lumen, or over time and after repeated ruptures, resulting in a persistent, usually localized stenosis or blockage of the artery lumen. Stenoses can be slowly progressive, whereas plaque ulceration is a sudden event that occurs specifically in atheromas with thinner/weaker fibrous caps that have become "unstable".

Repeated plaque ruptures, ones not resulting in total lumen closure, combined with the clot patch over the rupture and healing response to stabilize the clot is the process that produces most stenoses over time. The stenotic areas tend to become more stable despite increased flow velocities at these narrowings. Most major blood-flow-stopping events occur at large plaques, which, before their rupture, produced very little if any stenosis.

From clinical trials, 20% is the average stenosis at plaques that subsequently rupture with resulting complete artery closure. Most severe clinical events do not occur at plaques that produce high-grade stenosis. From clinical trials, only 14% of heart attacks occur from artery closure at plaques producing a 75% or greater stenosis before the vessel closing.

If the fibrous cap separating a soft atheroma from the bloodstream within the artery ruptures, tissue fragments are exposed and released. These tissue fragments are very clot-promoting, containing collagen and tissue factor; they activate platelets and activate the system of coagulation. The result is the formation of a thrombus (blood clot) overlying the atheroma, which obstructs blood flow acutely. With the obstruction of blood flow, downstream tissues are starved of oxygen and nutrients. If this is the myocardium (heart muscle) angina (cardiac chest pain) or myocardial infarction (heart attack) develops.

Accelerated growth of plaques

The distribution of atherosclerotic plaques in a part of arterial endothelium is inhomogeneous. The multiple and focal development of atherosclerotic changes is similar to that in the development of amyloid plaques in the brain and that of age spots on the skin. Misrepair-accumulation aging theory suggests that misrepair mechanisms play an important role in the focal development of atherosclerosis. Development of a plaque is a result of repair of injured endothelium. Because of the infusion of lipids into sub-endothelium, the repair has to end up with altered remodeling of local endothelium. This is the manifestation of a misrepair. Important is this altered remodeling makes the local endothelium have increased fragility to damage and have reduced repair efficiency. As a consequence, this part of endothelium has an increased risk factor of being injured and improperly repaired. Thus, the accumulation of misrepairs of endothelium is focalized and self-accelerating. In this way, the growing of a plaque is also self-accelerating. Within a part of the arterial wall, the oldest plaque is always the biggest, and is the most dangerous one to cause blockage of a local artery.

Components

The plaque is divided into three distinct components:

  1. The atheroma ("lump of gruel", from Greek ἀθήρα (athera) 'gruel'), which is the nodular accumulation of a soft, flaky, yellowish material at the center of large plaques, composed of macrophages nearest the lumen of the artery
  2. Underlying areas of cholesterol crystals
  3. Calcification at the outer base of older or more advanced lesions. Atherosclerotic lesions, or atherosclerotic plaques, are separated into two broad categories: Stable and unstable (also called vulnerable). The pathobiology of atherosclerotic lesions is very complicated, but generally, stable atherosclerotic plaques, which tend to be asymptomatic, are rich in extracellular matrix and smooth muscle cells. On the other hand, unstable plaques are rich in macrophages and foam cells, and the extracellular matrix separating the lesion from the arterial lumen (also known as the fibrous cap) is usually weak and prone to rupture. Ruptures of the fibrous cap expose thrombogenic material, such as collagen, to the circulation and eventually induce thrombus formation in the lumen. Upon formation, intraluminal thrombi can occlude arteries outright (e.g., coronary occlusion), but more often they detach, move into the circulation, and eventually occlude smaller downstream branches causing thromboembolism.

Apart from thromboembolism, chronically expanding atherosclerotic lesions can cause complete closure of the lumen. Chronically expanding lesions are often asymptomatic until lumen stenosis is so severe (usually over 80%) that blood supply to downstream tissue(s) is insufficient, resulting in ischemia. These complications of advanced atherosclerosis are chronic, slowly progressive, and cumulative. Most commonly, soft plaque suddenly ruptures, causing the formation of a thrombus that will rapidly slow or stop blood flow, leading to the death of the tissues fed by the artery in approximately five minutes. This event is called an infarction.

Diagnosis

CT image of atherosclerosis of the abdominal aorta. Woman of 70 years old with hypertension and dyslipidemia.
 
Microphotography of arterial wall with calcified (violet color) atherosclerotic plaque (hematoxylin and eosin stain)

Areas of severe narrowing, stenosis, detectable by angiography, and to a lesser extent "stress testing" have long been the focus of human diagnostic techniques for cardiovascular disease, in general. However, these methods focus on detecting only severe narrowing, not the underlying atherosclerosis disease. As demonstrated by human clinical studies, most severe events occur in locations with heavy plaque, yet little or no lumen narrowing present before debilitating events suddenly occur. Plaque rupture can lead to artery lumen occlusion within seconds to minutes, and potential permanent debility, and sometimes sudden death.

Plaques that have ruptured are called complicated plaques. The extracellular matrix of the lesion breaks, usually at the shoulder of the fibrous cap that separates the lesion from the arterial lumen, where the exposed thrombogenic components of the plaque, mainly collagen will trigger thrombus formation. The thrombus then travels downstream to other blood vessels, where the blood clot may partially or completely block blood flow. If the blood flow is completely blocked, cell deaths occur due to the lack of oxygen supply to nearby cells, resulting in necrosis. The narrowing or obstruction of blood flow can occur in any artery within the body. Obstruction of arteries supplying the heart muscle results in a heart attack, while the obstruction of arteries supplying the brain results in an ischaemic stroke.

Doppler ultrasound of right internal Carotid artery with calcified and non-calcified plaques showing less than 70% stenosis

Lumen stenosis that is greater than 75% was considered the hallmark of clinically significant disease in the past because recurring episodes of angina and abnormalities in stress tests are only detectable at that particular severity of stenosis. However, clinical trials have shown that only about 14% of clinically debilitating events occur at sites with more than 75% stenosis. The majority of cardiovascular events that involve sudden rupture of the atheroma plaque do not display any evident narrowing of the lumen. Thus, greater attention has been focused on "vulnerable plaque" from the late 1990s onwards.

Besides the traditional diagnostic methods such as angiography and stress-testing, other detection techniques have been developed in the past decades for earlier detection of atherosclerotic disease. Some of the detection approaches include anatomical detection and physiologic measurement.

Examples of anatomical detection methods include coronary calcium scoring by CT, carotid IMT (intimal media thickness) measurement by ultrasound, and intravascular ultrasound (IVUS). Examples of physiologic measurement methods include lipoprotein subclass analysis, HbA1c, hs-CRP, and homocysteine. Both anatomic and physiologic methods allow early detection before symptoms show up, disease staging, and tracking of disease progression. Anatomic methods are more expensive and some of them are invasive in nature, such as IVUS. On the other hand, physiologic methods are often less expensive and safer. But they do not quantify the current state of the disease or directly track progression. In recent years, developments in nuclear imaging techniques such as PET and SPECT have provided ways of estimating the severity of atherosclerotic plaques.

Prevention

Up to 90% of cardiovascular disease may be preventable if established risk factors are avoided. Medical management of atherosclerosis first involves modification to risk factors–for example, via smoking cessation and diet restrictions. Prevention then is generally by eating a healthy diet, exercising, not smoking, and maintaining a normal weight.

Diet

Changes in diet may help prevent the development of atherosclerosis. Tentative evidence suggests that a diet containing dairy products has no effect on or decreases the risk of cardiovascular disease.

A diet high in fruits and vegetables decreases the risk of cardiovascular disease and death. Evidence suggests that the Mediterranean diet may improve cardiovascular results. There is also evidence that a Mediterranean diet may be better than a low-fat diet in bringing about long-term changes to cardiovascular risk factors (e.g., lower cholesterol level and blood pressure).

Exercise

A controlled exercise program combats atherosclerosis by improving circulation and functionality of the vessels. Exercise is also used to manage weight in patients who are obese, lower blood pressure, and decrease cholesterol. Often lifestyle modification is combined with medication therapy. For example, statins help to lower cholesterol. Antiplatelet medications like aspirin help to prevent clots, and a variety of antihypertensive medications are routinely used to control blood pressure. If the combined efforts of risk factor modification and medication therapy are not sufficient to control symptoms or fight imminent threats of ischemic events, a physician may resort to interventional or surgical procedures to correct the obstruction.

Treatment

Treatment of established disease may include medications to lower cholesterol such as statins, blood pressure medication, or medications that decrease clotting, such as aspirin. A number of procedures may also be carried out such as percutaneous coronary intervention, coronary artery bypass graft, or carotid endarterectomy.

Medical treatments often focus on alleviating symptoms. However measures which focus on decreasing underlying atherosclerosis—as opposed to simply treating symptoms—are more effective. Non-pharmaceutical means are usually the first method of treatment, such as stopping smoking and practicing regular exercise. If these methods do not work, medicines are usually the next step in treating cardiovascular diseases and, with improvements, have increasingly become the most effective method over the long term.

The key to the more effective approaches is to combine multiple different treatment strategies. In addition, for those approaches, such as lipoprotein transport behaviors, which have been shown to produce the most success, adopting more aggressive combination treatment strategies taken on a daily basis and indefinitely has generally produced better results, both before and especially after people are symptomatic.

Statins

The group of medications referred to as statins are widely prescribed for treating atherosclerosis. They have shown benefit in reducing cardiovascular disease and mortality in those with high cholesterol with few side effects. Secondary prevention therapy, which includes high-intensity statins and aspirin, is recommended by multi-society guidelines for all patients with history of ASCVD (atherosclerotic cardiovascular disease) to prevent recurrence of coronary artery disease, ischemic stroke, or peripheral arterial disease. However, prescription of and adherence to these guideline-concordant therapies is lacking, particularly among young patients and women.

Statins work by inhibiting HMG-CoA (hydroxymethylglutaryl-coenzyme A) reductase, a hepatic rate-limiting enzyme in cholesterol's biochemical production pathway. By inhibiting this rate-limiting enzyme, the body is unable to produce cholesterol endogenously, therefore reducing serum LDL-cholesterol. This reduced endogenous cholesterol production triggers the body to then pull cholesterol from other cellular sources, enhancing serum HDL-cholesterol. These data are primarily in middle-age men and the conclusions are less clear for women and people over the age of 70.

Surgery

When atherosclerosis has become severe and caused irreversible ischemia, such as tissue loss in the case of peripheral artery disease, surgery may be indicated. Vascular bypass surgery can re-establish flow around the diseased segment of artery, and angioplasty with or without stenting can reopen narrowed arteries and improve blood flow. Coronary artery bypass grafting without manipulation of the ascending aorta has demonstrated reduced rates of postoperative stroke and mortality compared to traditional on-pump coronary revascularization.

Other

There is evidence that some anticoagulants, particularly warfarin, which inhibit clot formation by interfering with Vitamin K metabolism, may actually promote arterial calcification in the long term despite reducing clot formation in the short term. Also, single peptides such as 3-hydroxybenzaldehyde and protocatechuic aldehyde have shown vasculoprotective effects to reduce risk of atherosclerosis.

Epidemiology

Cardiovascular disease, which is predominantly the clinical manifestation of atherosclerosis, is the leading cause of death worldwide.

Etymology

The following terms are similar, yet distinct, in both spelling and meaning, and can be easily confused: arteriosclerosis, arteriolosclerosis, and atherosclerosis. Arteriosclerosis is a general term describing any hardening (and loss of elasticity) of medium or large arteries (from Greek ἀρτηρία (artēria) 'artery', and σκλήρωσις (sklerosis) 'hardening'); arteriolosclerosis is any hardening (and loss of elasticity) of arterioles (small arteries); atherosclerosis is a hardening of an artery specifically due to an atheromatous plaque (from Ancient Greek ἀθήρα (athḗra) 'gruel'). The term atherogenic is used for substances or processes that cause formation of atheroma.

Economics

In 2011, coronary atherosclerosis was one of the top ten most expensive conditions seen during inpatient hospitalizations in the US, with aggregate inpatient hospital costs of $10.4 billion.

Research

Lipids

An indication of the role of high-density lipoprotein (HDL) on atherosclerosis has been with the rare Apo-A1 Milano human genetic variant of this HDL protein. A small short-term trial using bacterial synthesized human Apo-A1 Milano HDL in people with unstable angina produced a fairly dramatic reduction in measured coronary plaque volume in only six weeks vs. the usual increase in plaque volume in those randomized to placebo. The trial was published in JAMA in early 2006. Ongoing work starting in the 1990s may lead to human clinical trials—probably by about 2008. These may use synthesized Apo-A1 Milano HDL directly, or they may use gene-transfer methods to pass the ability to synthesize the Apo-A1 Milano HDLipoprotein.

Methods to increase HDL particle concentrations, which in some animal studies largely reverses and removes atheromas, are being developed and researched. However, increasing HDL by any means is not necessarily helpful. For example, the drug torcetrapib is the most effective agent currently known for raising HDL (by up to 60%). However, in clinical trials, it also raised deaths by 60%. All studies regarding this drug were halted in December 2006.

The actions of macrophages drive atherosclerotic plaque progression. Immunomodulation of atherosclerosis is the term for techniques that modulate immune system function to suppress this macrophage action.

Involvement of lipid peroxidation chain reaction in atherogenesis triggered research on the protective role of the heavy isotope (deuterated) polyunsaturated fatty acids (D-PUFAs) that are less prone to oxidation than ordinary PUFAs (H-PUFAs). PUFAs are essential nutrients – they are involved in metabolism in that very form as they are consumed with food. In transgenic mice, that are a model for human-like lipoprotein metabolism, adding D-PUFAs to diet indeed reduced body weight gain, improved cholesterol handling and reduced atherosclerotic damage to the aorta.

miRNA

MicroRNAs (miRNAs) have complementary sequences in the 3' UTR and 5' UTR of target mRNAs of protein-coding genes, and cause mRNA cleavage or repression of translational machinery. In diseased vascular vessels, miRNAs are dysregulated and highly expressed. miR-33 is found in cardiovascular diseases. It is involved in atherosclerotic initiation and progression including lipid metabolism, insulin signaling and glucose homeostatis, cell type progression and proliferation, and myeloid cell differentiation. It was found in rodents that the inhibition of miR-33 will raise HDL level and the expression of miR-33 is down-regulated in humans with atherosclerotic plaques.

miR-33a and miR-33b are located on intron 16 of human sterol regulatory element-binding protein 2 (SREBP2) gene on chromosome 22 and intron 17 of SREBP1 gene on chromosome 17. miR-33a/b regulates cholesterol/lipid homeostatis by binding in the 3’UTRs of genes involved in cholesterol transport such as ATP binding cassette (ABC) transporters and enhance or represses its expression. Study have shown that ABCA1 mediates transport of cholesterol from peripheral tissues to Apolipoprotein-1 and it is also important in the reverse cholesterol transport pathway, where cholesterol is delivered from peripheral tissue to the liver, where it can be excreted into bile or converted to bile acids prior to excretion. Therefore, we know that ABCA1 plays an important role in preventing cholesterol accumulation in macrophages. By enhancing miR-33 function, the level of ABCA1 is decreased, leading to decrease cellular cholesterol efflux to apoA-1. On the other hand, by inhibiting miR-33 function, the level of ABCA1 is increased and increases the cholesterol efflux to apoA-1. Suppression of miR-33 will lead to less cellular cholesterol and higher plasma HDL level through the regulation of ABCA1 expression.

The sugar, cyclodextrin, removed cholesterol that had built up in the arteries of mice fed a high-fat diet.

DNA damage

Aging is the most important risk factor for cardiovascular problems. The causative basis by which aging mediates its impact, independently of other recognized risk factors, remains to be determined. Evidence has been reviewed for a key role of DNA damage in vascular aging. 8-oxoG, a common type of oxidative damage in DNA, is found to accumulate in plaque vascular smooth muscle cells, macrophages and endothelial cells, thus linking DNA damage to plaque formation. DNA strand breaks also increased in atherosclerotic plaques. Werner syndrome (WS) is a premature aging condition in humans. WS is caused by a genetic defect in a RecQ helicase that is employed in several repair processes that remove damages from DNA. WS patients develop a considerable burden of atherosclerotic plaques in their coronary arteries and aorta: calcification of the aortic valve is also frequently observed. These findings link excessive unrepaired DNA damage to premature aging and early atherosclerotic plaque development.

Microorganisms

The microbiota – all the microorganisms in the body, can contribute to atherosclerosis in many ways: modulation of the immune system, changes in metabolism, processing of nutrients and production of certain metabolites that can get into blood circulation. One such metabolite, produced by gut bacteria, is trimethylamine N-oxide (TMAO). Its levels have been associated with atherosclerosis in human studies and animal research suggest that there can be a causal relation. An association between the bacterial genes encoding trimethylamine lyases — the enzymes involved in TMAO generation — and atherosclerosis has been noted.

Vascular smooth muscle cells

Vascular smooth muscle cells play a key role in atherogenesis and were historically considered to be beneficial for plaque stability by forming a protective fibrous cap and synthesising strength-giving extracellular matrix components. However, in addition to the fibrous cap, vascular smooth muscle cells also give rise to many of the cell types found within the plaque core and can modulate their phenotype to both promote and reduce plaque stability. Vascular smooth muscle cells exhibit pronounced plasticity within atherosclerotic plaque and can modify their gene expression profile to resemble various other cell types, including macrophages, myofibroblasts, mesenchymal stem cells and osteochondrocytes. Importantly, genetic lineage‐tracing experiments have unequivocally shown that 40-90% of plaque-resident cells are vascular smooth muscle cell derived. Therefore, it is important to research the role of vascular smooth muscle cells in atherosclerosis to identify new therapeutic targets.

Introduction to entropy

From Wikipedia, the free encyclopedia https://en.wikipedia.org/wiki/Introduct...