Chapter 24 - Extracellular matrix dynamics and contribution to vascular pathologies

Abstract

The matrix microenvironment changes dramatically in vascular disease. Driven by changes in physical forces, especially blood flow and pressure, cells are stimulated to remodel the extracellular matrix (ECM), attempting to protect and repair damaged blood vessels. Dynamic ECM remodeling occurs during atherosclerosis, hypertension, and aneurysm formation. There is ECM turnover, accumulation of degradation products, and deposition of new ECM molecules not normally present in healthy vessels. It is now recognized that the ECM serves not just as a scaffold, but also as a signaling ligand influencing cellular responses to injury and phenotypic changes. This signaling is powerful, because it has the potential to act along two axes, transducing biophysical signals from a progressively stiffening ECM, and initiating biochemical signals as the composition of the ECM changes. This chapter focuses mainly on the interplay between vascular smooth muscle cells and their dynamic ECM in atherosclerosis, arterial stiffening, and aneurysm formation.