Fluid Shear Stress-Regulated Vascular Remodeling: Past, Present, and Future

Area of Science:

• Cardiovascular Biology
• Physiology
• Endothelial Cell Biology

Background:

• The vascular system dynamically remodels throughout life to meet tissue perfusion demands.
• Capillary density is regulated by angiogenesis and regression.
• Arterial diameter adjusts to optimize blood flow, influenced by endothelial cells sensing fluid shear stress (FSS).

Purpose of the Study:

• To review endothelial FSS-dependent vascular remodeling.
• To provide insights into potential therapeutic interventions for vascular diseases.
• To summarize knowledge on mechanisms, models, and clinical implications of FSS-mediated remodeling.

Main Methods:

• Historical overview of vascular remodeling research.
• Discussion of set point concepts and low/high FSS-mediated remodeling mechanisms.
• Review of in vivo animal models, molecular mechanisms, and clinical implications.

Main Results:

• Endothelial cells sense FSS, leading to inward or outward remodeling of arteries.
• Changes in FSS stimulate adaptive remodeling of upstream arteries.
• Physiological FSS-mediated remodeling is crucial for vascular health.

Conclusions:

• Understanding endothelial FSS-mediated vascular remodeling is key to developing new therapies.
• Failure of FSS-mediated remodeling due to stress or mutations contributes to vascular diseases.
• Targeting FSS responses may prevent or treat vascular pathologies.