69 - Endothelial Cell and Smooth Muscle Cell Biology in Vascular Disease

Abstract

This chapter reviews in vivo and in vitro methods used to address various questions regarding the vascular response to injury. The tools of biochemistry, biophysics, cell biology, physiology, pharmacology, and pathology are used to study the vascular response to injury and other vascular diseases. Cells of the vascular wall—endothelial cells, smooth muscle cells, and fibroblasts—are central to normal function of the vessel as a conduit for blood. Endothelial cells provide a nonthrombogenic surface and mediate the effects of shear forces and blood-borne growth factors and cytokines. Smooth muscle cells and adventitial fibroblasts play a dynamic role in the structure and tone of the vessel, thus regulating luminal area. These cells, which are coupled through complex autocrine and paracrine interactions, also play critical roles in the pathogenesis of atherosclerotic and aneurysmal degeneration of the vessel wall. Stroke, angina, myocardial infarction, and claudication result from atherosclerotic disease, which is thought to be the result of recurrent endothelial cell injury. Ironically, the surgical- and catheter-based interventions available for treatment of diseased arteries (endarterectomy, bypass grafting, percutaneous transluminal coronary angioplasty, directional and rotational atherectomy, and stents) are themselves injurious and have significant failure rates because of luminal narrowing. Thus, understanding how the arterial wall and its component cells respond to injury and the regulatory factors involved in these responses will ultimately lead to better treatments for vascular disease.