Blood pressure regulation VIII: resistance vessel tone and implications for a pro-atherogenic conduit artery endothelial cell phenotype.

Blood pressure regulation VIII: resistance vessel tone and implications for a pro-atherogenic conduit artery endothelial cell phenotype.
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DOI:
10.1007/s00421-013-2684-x
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发表时间:
2014-03
影响因子:
3
通讯作者:
Fadel, Paul J.
Fadel, Paul J.
中科院分区:
医学3区
文献类型:
--
作者:
Padilla, Jaume;Jenkins, Nathan T.;Laughlin, M. Harold;Fadel, Paul J.

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内皮功能障碍被认为是动脉粥样硬化性外周动脉疾病的主要发起者,这种疾病主要发生在下肢的中、大导管动脉(如髂动脉、股动脉、腘动脉)。在这篇综述文章中,我们提出了一个新的概念,即导管动脉内皮细胞的表型部分是由骨骼肌阻力动脉的微血管张力决定的,通过动脉血压的变化和上游导管动脉剪切应力模式的变化。首先,我们总结了支持交感神经活动(SNA)和一氧化氮(NO)参与微血管张力和动脉血压调节的文献。然后,我们关注血压升高和剪切应力在调节导管动脉内皮细胞表型中的作用。最后,我们讨论了经典研究和新兴研究的发现,这些研究表明,在SNA增加和/或NO生物利用度降低的背景下,血管阻力的增加与上游导管动脉中更大的振荡剪切应力(例如,逆行剪切增加)有关。本综述提出的观点为微血管张力增加与导管动脉内皮功能障碍发展之间的机制联系奠定了新的范式,从而增加了外周动脉疾病的风险。事实上,大量的证据支持这样一种观点,即血压过高和振荡剪切应力是内皮细胞强有力的促动脉粥样硬化信号。
Dysfunction of the endothelium is proposed as the primary initiator of atherosclerotic peripheral artery disease, which occurs mainly in medium to large-sized conduit arteries of the lower extremities (e.g., iliac, femoral, popliteal arteries). In this review article, we propose the novel concept that conduit artery endothelial cell phenotype is determined, in part, by microvascular tone in skeletal muscle resistance arteries through both changes in arterial blood pressure as well as upstream conduit artery shear stress patterns. First, we summarize the literature supporting the involvement of sympathetic nerve activity (SNA) and nitric oxide (NO) in the modulation of microvascular tone and arterial blood pressure. We then focus on the role of elevated blood pressure and shear stress profiles in modulating conduit artery endothelial cell phenotype. Last, we discuss findings from classic and emerging studies indicating that increased vascular resistance, as it occurs in the context of increased SNA and/or reduced NO bioavailability, is associated with greater oscillatory shear stress (e.g., increased retrograde shear) in upstream conduit arteries. The ideas put forth in this review set the stage for a new paradigm concerning the mechanistic link between increased microvascular tone and development of conduit artery endothelial dysfunction and thus increased risk for peripheral artery disease. Indeed, a vast amount of evidence supports the notion that excessive blood pressure and oscillatory shear stress are potent pro-atherogenic signals to the endothelium.
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