Endothelial dysfunction and monocyte recruitment in cells exposed to non-uniform shear stress

Atherosclerosis results from a combination of local blood flow patterns and systemic risk factors. We investigated whether non-uniform shear stress at bifurcations induces pro-atherogenic endothelial dysfunction and monocyte recruitment. Bifurcating flow-through cell culture slides were used to expose HUVECs to laminar or non-uniform shear stress for 18 h at 10 dyne/cm(2). For the adhesion assay, HUVECs were subsequently perfused with medium containing THP-1 monocytes for 1 h. Protein expression was determined by immunofluorescence. In areas exposed to laminar shear stress, alignment of endothelial cells with the flow was observed, accompanied by upregulation of eNOS and downregulation of connective tissue growth factor (CTGF). In contrast, cells exposed to non-uniform shear stress near the outer walls of bifurcations were characterized by irregular, unaligned shape, induction of endothelin-1 and CTGF, as well as reduced eNOS expression. These atherogenic effects of non-uniform shear stress were prevented when cells were treated with statins (1 mumol/l) during flow. Under non-uniform shear stress, a slight induction of VCAM-1, ICAM-1, and E-/P-selectin was observed. In agreement with this, monocyte recruitment, which was nearly undetectable under laminar shear stress, was moderately induced by non-uniform shear stress (P<0.02). In conclusion, inhibition of antioxidative eNOS and upregulation of atherogenic proteins is the first step in non-uniform shear stress-mediated endothelial dysfunction, which in vivo in the presence of atherogenic risk factors may further enhance monocyte recruitment into the artery wall.