ABSTRACT
Vyacheslav A. Korshunov Vyacheslav “Slava” A. Korshunov, Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester School of Medicine and
Dentistry, 601 Elmwood Avenue, Box CVRI Rochester, NY 14642 E-mail: Slava_Korshunov@URMC.rochester.edu
Cell death is an important process during the development of the vasculature, where it counteracts an enormous amount of cell division. Apoptosis is found at very low levels in the blood vessels in adults. However, a signifi cant increase in apoptosis is typical for vascular diseases. Vascular wall response (‘vascular remodeling’) that occurs during vascular disease involves apoptosis. Studies of rare vascular genetic disorders as well as experimental and clinical data on common vascular diseases provide valuable information on multiple pathophysiological mechanisms that control vascular apoptosis. An imbalance of pro-apoptotic and anti-apoptotic pathways in various cell types (endothelial, smooth muscle, or infl ammatory cells), and the stage of the disease (early vs advanced) can determine outcomes of apoptosis on vascular disease progression. In fact, normal arteries are less tolerated to endothelial than smooth muscle cell death. Apoptosis of the infl ammatory and smooth muscle cells is very harmful for advanced vascular diseases (e.g., atherosclerotic plaque rupture). Alterations in hemodynamic forces (blood pressure and shear stress) appeared to be critical regulators of vascular apoptosis. In summary, vascular apoptosis is an important feature of vascular diseases that are induced via many mechanisms and manipulation of both pro-and anti-apoptotic pathways may potentially reverse pathological vascular remodeling.
