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The chronic inflammation process that characterises atherosclerosis involves both the innate and adaptive arms of the immune system. Several lines of evidence have recently highlighted pivotal roles for T and B lymphocytes - cells that belong to the adaptive immune system - in the development and progression of atherosclerosis. In this review, we summarise the current knowledge on the roles of adaptive immune responses in atherosclerosis and present our views on how a better understanding of these immune mechanisms could shape future therapies to slow down or even prevent this disease.