Nitric oxide in endothelial dysfunction and vascular remodeling: Clinical correlates and experimental links
Nitric oxide in endothelial dysfunction and vascular remodeling: Clinical correlates and experimental links
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DOI：
10.1086/302304
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发表时间：
1999-03-01
影响因子：
9.8
通讯作者：
Sessa, WC
中科院分区：
文献类型：
--
作者：
Rudic, RD;Sessa, WC
血管系统的通畅性对于维持正常组织功能至关重要。幸运的是，血管细胞（内皮细胞、平滑肌细胞和成纤维细胞）的遗传程序赋予了它们对生理和病理生理刺激做出反应的能力，并根据组织的代谢需求重新排列其结构以维持足够的血流。通过交感神经系统和血管活性因子控制血管收缩，可以快速校准管腔直径。长期的结构适应，可能反映了许多短期血管扩张事件的总和，通过一个称为“血管重塑”的过程发生。血管重塑是血管壁响应于慢性刺激而重组其细胞和细胞外组分的能力（Gibbons和Dzau 1994）。实验研究表明，由于动静脉分流导致的血流量增加会增加血管直径;相反，血流量减少会减少血管直径。基于这些发现，人们认为，血流的慢性减少引发了一个信号级联，导致血管剧烈收缩并重塑自身，从而形成更小的血管腔。这种重塑降低了由较低流速施加的剪切应力和周向壁应变（Kamiya和Togawa 1980; Langille和奥唐纳1986）。血管系统的分层结构有助于信息从血管腔传递到下面的平滑肌，然后传递到周围组织。同样地，血管响应神经输入和组织因子以影响平滑肌和内皮。血管的位置
The patency of the vascular system is essential to maintain normal tissue function. Fortunately for us, the genetic program of vascular cells (endothelial cells, smooth muscle cells, and fibroblasts) endows them with the capacity to respond to physiological and pathophysiological stimuli and to rearrange their architecture to maintain adequate blood flow according to the metabolic demand of the tissue. Rapid calibration of lumen diameter can occur through vasomotor control governed by the sympathetic nervous sytem and vasoactive factors. Long-term structural adaptation, perhaps reflecting the summation of many short-term vasomotor events, occurs through a process called “vascular remodeling.” Vascular remodeling is the ability of the vessel wall to reorganize its cellular and extracellular components in response to a chronic stimulus (Gibbons and Dzau 1994). Experimental studies have shown that increases in blood flow due to an arteriovenous shunt will increase vessel diameter; conversely, reductions in blood flow will reduce vascular diameter. On the basis of these findings, it is believed that chronic reduction in blood flow initiates a signaling cascade that leads blood vessels to contract acutely and remodel themselves, creating a smaller vascular lumen. This remodeling reduces the shear stress and the circumferential wall strain imposed by the lower flow rates (Kamiya and Togawa 1980; Langille and O’Donnell 1986). The layered structure of the vascular system facilitates information transfer from the lumen of the vessel into the underlying smooth muscle and then to surrounding tissue. Likewise, the vessel responds to neural input and tissue factors to influence the smooth muscle and the endothelium. The position of the vascular