Mechanisms of vascular smooth muscle cell proliferation

Proliferation of vascular smooth muscle cells (VSMCs) is an important pathological event in a number of vascular disease processes including atherosclerosis, the response to endothelial injury, vascular rejection and hypertension. The biochemical mechanisms underlying VSMC proliferation and the precise chemical stimuli for the initiation and maintenance of proliferation are poorly understood. In this review, the biochemical basis for a phenotypic transition and its requirement for VSMC proliferation are discussed along with potential mechanisms for the induction of VSMC proliferation by conventional mitogens and vasoconstrictor agonists. Finally the prospect for therapeutic pharmacological intervention is reviewed.