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Acta Physiol (Oxf). 2017 Feb;219(2):382-408. doi: 10.1111/apha.12725. Epub 2016 Jun 19.

Effects of shear stress on endothelial cells: go with the flow.

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Department of Medical Nanobiotechnology, Pirogov Russian State Medical University, Moscow, Russia.
Institute of General Pathology and Pathophysiology, Russian Academy of Medical Sciences, Moscow, Russia.
Institute for Atherosclerosis Research, Skolkovo Innovative Center, Moscow, Russia.
Department of Biophysics, Biological Faculty, Moscow State University, Moscow, Russia.
Faculty of Medicine and St Vincent's Centre for Applied Medical Research, University of New South Wales, Sydney, NSW, Australia.
School of Medicine, University of Western Sydney, Campbelltown, NSW, Australia.


Haemodynamic forces influence the functional properties of vascular endothelium. Endothelial cells (ECs) have a variety of receptors, which sense flow and transmit mechanical signals through mechanosensitive signalling pathways to recipient molecules that lead to phenotypic and functional changes. Arterial architecture varies greatly exhibiting bifurcations, branch points and curved regions, which are exposed to various flow patterns. Clinical studies showed that atherosclerotic plaques develop preferentially at arterial branches and curvatures, that is in the regions exposed to disturbed flow and shear stress. In the atheroprone regions, the endothelium has a proinflammatory phenotype associated with low nitric oxide production, reduced barrier function and increased proadhesive, procoagulant and proproliferative properties. Atheroresistant regions are exposed to laminar flow and high shear stress that induce prosurvival antioxidant signals and maintain the quiescent phenotype in ECs. Indeed, various flow patterns contribute to phenotypic and functional heterogeneity of arterial endothelium whose response to proatherogenic stimuli is differentiated. This may explain the preferential development of endothelial dysfunction in arterial sites with disturbed flow.


atherogenesis; atherosclerosis; endothelial cells; mechanotransduction; shear stress; vascular smooth muscle cells

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