Blood flow-induced remodeling of arteries in health and disease

Vascular structures readily remodel in response to hemodynamic cues associated with changes in blood flows. These remodeling processes are invoked by a wealth of developmental, physiological, and pathological phenomena. Current work is providing novel clues concerning flow sensing by endothelial cells, the signal transduction pathways that translate flow detection into endothelial responses, and some of the signals that are transmitted to the effector cells, the vascular smooth muscle cells in the media. However, most of these mechanisms relate to acute responses to altered flow, and how important they are in eliciting tissue remodeling is unknown. Also, there is very little information on the processes that accomplish "modeling," beyond evidence that modulation of new tissue synthesis occurs. There is a potential for experiments in the near future to provide fundamental information on the genesis of the vascular structure-function relations, which now clearly spans much of the pre- and postnatal life.