Gallstones occurring in industrialized societies typically contain more than 70-90% cholesterol by weight, much of which is crystalline.
[1] Cholesterol crystals are a hallmark of atherosclerosis, which is believed to be an early cause of atherosclerotic inflammation.
[2] Cholesterol phase transition from liquid to crystalline form is linked to inflammation.
[3] Cholesterol crystals are believed to induce inflammation by activation of the NLRP3 inflammasome.
[4][5] In addition to being a source of inflammation, cholesterol crystals are believed to cause mechanical injury by tearing tissue, causing plaque rupture.