Arteriosclerosis, Thrombosis, and Vascular Biology. 1997;17:1868-1871
© 1997 American Heart Association, Inc.
Articles |
Cellular Heterogeneity of the Vascular Tunica Media
Implications for Vessel Wall Repair
From the Department of Medicine, Baylor College of Medicine, Houston, Tex.
Correspondence to Charles L. Seidel, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030. E-mail cseidel@bcm.tmc.edu
Key Words: • neointimal cells • stem cells • vascular wall repair
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The Problem |
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Following arterial injury in adult humans and other mammals, there occurs a thickening of the intimal layer of the vessel wall due to migration of cells from the tunica media and proliferation of these migrated cells, along with any resident intimal cells. This intimal thickening, or neointimal formation, can lead to vessel stenosis or even occlusion and is the cellular basis of all intimal vascular disease. An understanding of this process leading to prevention, retardation, or reversal of intimal thickening would dramatically reduce morbidity and mortality from vascular disease.
The identity of the cells involved in intimal thickening has not been
conclusively determined. The morphology, growth properties, and protein
expression of cells in the thickened intima are distinct from those of
vascular smooth muscle cells within the tunica media or of
endothelial cells lining the vessel lumen. There are at
least three hypotheses to explain the identity of
neointimal cells: (1) They arise from fully differentiated
vascular smooth muscle cells within the tunica media. During their
migration to and proliferation in the intimal layer, they undergo
function-specific modifications, thus acquiring the characteristics
ascribed to neointimal cells. (2) They arise from a
normally resident population of smooth muscle "stem cells." Such
cells may be embryonic or fetal smooth muscle cells that have not fully
differentiated or a multipotential cell that could form either
neointimal or smooth muscle cells. Unlike differentiated
smooth muscle cells, these cells would retain the ability to migrate
and proliferate. During migration to and subsequent proliferation
within the
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