Flow-dependent regulation of vascular function

Abstract

Flow-dependent regulation of vascular function John A. Bevan, Gabor Kaley, Gabor M. Rubanyi, New York, 1995, Oxford University Press, 371 pages, $85. Blood flow affects atherogenesis, intimal hyperplasia, thrombosis, and vascular tone. The influence of flow on vascular disease is so pervasive that anyone doing research in related areas must be familiar with the growing body of work in this field. Flow-Dependent Regulation of Vascular Function is an excellent review of this topic. This book is the latest volume in the distinguished Clinical Physiology Series from the American Physiological Society. It covers flow-dependent regulation of vascular function from the molecular to the large-vessel level. The editors have gathered many of the most influential investigators in the field to give an overview and update in their areas of expertise. Each chapter has an extensive bibliography, which includes important historic and recent literature. The result is an impressive review and update. The first section deals with biophysical and biochemical aspects of the circulation as a whole, including the biophysical principles of fluid transport and cellular signal transduction. The section on hemodynamics attempts to cover a lot of material in a small space. This makes for a challenging review and is not a substitute for a good hemodynamics text. The book's first chapter is a broad overview of the design of fluid transport systems. In it, we learn the physical principles that influence the overall structure of circulatory systems, and in passing we gain a greater appreciation for the bigger picture. For example, we learn that the tube worm Chaetopterus variopedatus pumps the equivalent of its total body volume each second! Subsequent chapters by Davies on flow-mediated signal transduction in endothelial cells, Diamond and McIntire on gene regulation, and Berthiaume and Frabgos on the effects of flow on endothelial cell mediator production are excellent reviews of these topics, which are more directly related to vascular disease. The second section of the book deals with regulation of vascular muscle tone by flow. It includes discussion of the influence of flow on vasomotor activity, platelet function, and regulation of the microcirculation. This section delves into molecular biology, including a discussion of candidate molecules that may act as transducers of mechanical shear into biochemical signals. The chapter on endothelium-derived relaxing factor, which includes a review of the biochemistry involved, is particularly pertinent. This molecule is not only a critical regulator of vascular tone but also can influence wall structure by modulating smooth muscle cell growth. The final section of the book deals with flow-induced remodeling and regulation of vascular function in disease states. The review of blood flow-induced remodeling of the artery wall by Langille is superb. The chapter on the effects of blood flow on atherosclerosis is a reasonably good review that can serve as a starting point for those who have a particular interest in this topic. The final two chapters discuss the role of the endothelium in coronary vasospasm and atherosclerosis. Although a few of the chapters are poorly illustrated and some of the material is arcane (the analysis of tube worm circulation, for example), the writing of this multiauthored text is of consistently high quality. Most authors have given us an extensive, detailed overview of their topic, with a comprehensive bibliography. They are recognized experts, and many have been the pioneer investigators in the fields they discuss. Often the subject matter overlaps, and critical data are discussed by more than one author. Rather than being simply repetitious, however, this affords us several different views of the same experimental observations and reinforces and broadens our understanding of the material. We find that the editors were correct in stating that, "Investigators often diverge in their opinions regarding the nature of the vascular wall response to blood flow and mechanisms involved." The editors have succeeded in their attempt to provide a succinct "summary of our state of knowledge and the nature of the research carried out on flow-related changes." This book will be a valuable addition to any laboratory investigating blood vessel pathophysiology.