ABSTRACT
The atherosclerotic plaque is composed largely of vascular smooth muscle cells, macrophages and T lymphocytes surrounding a lipid core. Apoptosis of vascular cells is also the basis for the generation of microparticles within the circulation that act as potent procoagulant substrates both locally and systemically. Vascular smooth muscle cells within the vessel walls are able to proliferate, migrate, synthesize, and degrade extracellular matrices upon receiving appropriate stimuli. Vessel wall remodelling is a condition in which alterations in luminal size can occur through processes that do not necessarily require large changes in overall cell number or tissue mass. Acute arterial injury, such as that occurring at angioplasty, is followed by rapid induction of medial cell apoptosis, at least in animal models. Therapeutic induction of apoptosis in the vessel wall may also be limited by important sequelae. In contrast to the prevailing notion that apoptotic deaths are effectively silent, a number of deleterious effects of apoptotic cells have emerged within the vasculature.
