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Hypertension. 1995;25:464-473

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(Hypertension. 1995;25:464-473.)
© 1995 American Heart Association, Inc.


Articles

Regional Heterogeneity of Arterial Structural Changes

Mat J.A.P. Daemen; Jo G.R. De Mey

From the Departments of Pathology (M.J.A.P.D.) and Pharmacology (J.G.R. De M.), Cardiovascular Research Institute Maastricht, University of Limburg, Maastricht, Netherlands.

Correspondence to Dr J.G.R. De Mey, Department of Pharmacology, University of Limburg, PO Box 616, 6200 MD Maastricht, Netherlands.


*    Abstract
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*Abstract
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down arrowHeterogeneity of Vascular Growth...
down arrowWhat Causes Heterogeneity?
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Abstract Arterial structural changes in experimental models of hypertension and restenosis differ between vessel types and within vessels. Inspired by the diversity of short-term functional responses to vasoactive agents, hypotheses are presented with respect to the heterogeneity of structural alterations. Considered are the multifactorial nature of smooth muscle cell growth control and the possibility that vascular smooth muscle is not homogeneous but composed of different smooth muscle cell populations. These hypotheses may help explain the origin of both intervascular and intravascular heterogeneity of vascular structural responses.


Key Words: muscle, smooth • endothelium • nerves • angiotensin II • arteries


*    Introduction
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up arrowAbstract
*Introduction
down arrowVascular Heterogeneity in...
down arrowHeterogeneity of Vascular Growth...
down arrowWhat Causes Heterogeneity?
down arrowSummary and Perspective
down arrowReferences
 
A great deal of our current knowledge of the vascular wall has been based on studies of vascular cells in culture and on the contractile reactivity of isolated vessel strips. Often, articles trying to explain in vivo phenomena will discuss these in vitro data in an indiscriminate fashion. However, there are indications that smooth muscle cells (SMCs) may be heterogeneous and exposed to different combinations of stimuli and inhibitors at different locations along the vascular system. In this article we illustrate the various presentations and possible origins of heterogeneity of structural vascular responses and the role of angiotensin II (Ang II), nerves, and the endothelium. We will consider both differences between vessel segments and the diversity of vascular SMCs.


*    Vascular Heterogeneity in General
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up arrowAbstract
up arrowIntroduction
*Vascular Heterogeneity in...
down arrowHeterogeneity of Vascular Growth...
down arrowWhat Causes Heterogeneity?
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Short-term pharmacological observations indicate that several types and levels of vascular heterogeneity may be distinguished (Table 1). Documented most extensively are differences between vessel types, ie, intervascular heterogeneity. These differences may be quantitative or qualitative. They may be observed between the same type of vessel of different species, between vessels of different vascular beds in the same species, and between branches of the same vascular bed.1 2 Not all intervascular heterogeneity is due to diversity of innervation, the endothelium, and other intravascular sources of bioactive agents but may reside in regional differences of the vascular smooth muscle. Thus, vascular smooth muscle heterogeneity does not coincide with vascular heterogeneity. Furthermore, recent observations suggest that the SMCs that make up the media of a given vascular segment are not necessarily homogeneous3 4 (see below). This intravascular heterogeneity of SMCs has largely been overlooked by functional vascular studies. From a mechanistic point of view, it may also be helpful to distinguish between stable and reversible forms of vascular heterogeneity to discriminate between rather short-term environmental influences on vascular properties (such as receptor downregulation and tolerance of biochemical pathways) and poorly reversible decisions made at the molecular level in the cell types involved (such as phenotypic and genotypic differences). Possibly related to this aspect are different responses in vessels of fetal, young, adult, and old animals (heterogeneity in time).


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Table 1. Forms of Intervascular Heterogeneity


*    Heterogeneity of Vascular Growth Responses
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up arrowVascular Heterogeneity in...
*Heterogeneity of Vascular Growth...
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Structural changes in the vasculature play an important role in cardiovascular diseases.5 6 In general, two major types of structural changes can be distinguished: (1) alterations in the branching, length, and number of microvessels and (2) changes in the thickness and organization of the vascular wall (Fig 1). This review will consider only the latter radial changes.



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Figure 1. Schematic representation shows vascular growth responses. Top, Longitudinal network changes; middle, increases in arterial wall mass; and bottom, cellular changes contributing to medial hypertrophy. That these would be limited to a subset of growth-prone arterial smooth muscle cells is hypothetical. IHP indicates intimal hyperplasia; MHT, medial hypertrophy; RM, remodeling; CHT, cellular hypertrophy; and HP, hyperplasia.

Growth and proliferation of SMCs participate in medial hypertrophy in hypertension5 7 8 and in intimal thickening in atherosclerosis9 10 and restenosis after angioplasty.11 In recent years, SMC growth control has been the subject of extensive investigations in a limited number of experimental models. Widely used are culture of isolated aortic SMCs12 and structural responses of the aorta and carotid arteries to hypertension13 or balloon catheter injury.14 These models have helped make it increasingly clear that many factors are involved in SMC growth control. Growth factors, cytokines, and extracellular matrix components have received much attention.5 15 16 17 18 19 However, mechanical factors, neurotransmitters, hormones, and autacoids15 16 20 also participate.16 21 22 23 Multifactorial control of SMC growth provides ample opportunity for heterogeneous structural changes in blood vessels. Also in this case different types and levels of heterogeneity can be distinguished. It may be important to note that besides true differences between experimental models, differences between experimental protocols and the normotensive controls used may also account for some of the divergent findings.

Differences Between Blood Vessels or Intervascular Heterogeneity
Cell Culture
Enzymes and explants have been used to isolate SMCs (cells expressing smooth muscle {alpha}-actin when maintained at high density) from various blood vessels.12 SMCs isolated from large arteries of adult mammals lack contact inhibition and proliferate rapidly in a serum-dependent manner. For several species, the population doubling time of large-artery SMCs ranges between 20 and 30 hours. Yet microvascular SMCs obtained from rat mesentery need 3 to 6 days to replicate under identical conditions.24 Furthermore, cultured aortic SMCs of newborn rats differ from those of adult rats in several respects. They show platelet-derived growth factor (PDGF)–independent growth and constitutively secrete PDGF, express specific genes, and have a distinct epithelial morphology. Cultures of medial SMCs from adult animals show none of these properties and have the usual hill-and-valley morphology.25 26 These differences and the difference between adult microvascular and adult large-artery SMCs persist after several passages in vitro, suggesting stable heterogeneity.24 25 This is also the case for the different growth characteristics, differences in growth-related signal transduction pathways, and differences in the production of growth-affecting mediators and extracellular matrix (ECM) components observed between aortic SMCs of spontaneously hypertensive rats (SHR) and normotensive Wistar-Kyoto rats (WKY).27 28 29 30

Organ Culture
Exposure of isolated arterial segments of humans,31 pigs,32 rabbits,33 34 and rats24 35 to serum or growth factors stimulates DNA synthesis in a variable fraction of the SMCs that populate the intact media. For instance, in rat arteries we observed a 10-fold difference between vessels of different anatomic origin with respect to the fraction of SMCs that could be stimulated to synthesize DNA in vitro.24 The differences in DNA synthesis between the vessel types occurred despite identical proliferation rates of isolated SMCs put into cell culture.

Arterial Injury
Retraction of an inflated balloon through the lumen of a blood vessel removes the endothelium and damages the media.36 This ultimately gives rise to extensive SMC proliferation in the intima. This structural response to injury differs among vessel types and species (Table 2). For instance, in the rat carotid artery, neointima formation is circular, whereas it is largely restricted to the ventral surface in the rat thoracic aorta.41 In addition, the extent of neointima formation, defined as the ratio of intima to media mass, varies among vessel types and species (Table 2).


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Table 2. Interspecies and Intervascular Heterogeneity of the Arterial Structural Response to Balloon Injury

Hypertension
The type of arterial wall mass change in hypertension differs along the arterial tree. Regional comparative studies have been performed most extensively in SHR (Table 3). The predominant alteration of large arteries in established genetic hypertension consists of medial SMC hypertrophy and hyperploidy.13 18 However, small resistance-sized arteries show hyperplastic changes1 8 46 49 51 52 53 without an increased incidence of SMC polyploidy.8 42 54 The wall mass of arterioles, on the other hand, may be normal in SHR47 55 56 57 and the number of capillaries reduced.58 59 60 Hyperplasia is not a general finding in resistance arteries; it was found in some but not all vascular beds of SHR50 and was reported to be absent in renal hypertensive rats,61 mouse Ren-2 renin transgenic rats,62 and humans with essential hypertension.63 In recent studies64 65 of DNA synthesis in the arterial system of SHR, a marked heterogeneity was observed. DNA synthesis was elevated in mesenteric resistance arteries of SHR at 1 week of age but not at 2, 4, or 6 weeks of age. However, in various large arteries of the same strain, intra-arterial DNA synthesis was significantly elevated from 6 weeks of age but not at earlier developmental stages.64 65 66


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Table 3. Intervascular Heterogeneity of Arterial Structural Changes in Adult Spontaneously Hypertensive Rats

Pharmacological Interventions
Many drugs can influence arterial structural responses. Effects of antihypertensive agents on arterial wall hypertrophy and effects of various classes of agents on neointima formation after balloon injury have recently been reviewed.67 68 Here we will limit ourselves to the diverse effects of interventions in the renin-angiotensin and sympathetic nervous systems. Both systems interact in the control of arterial structural responses because (1) angiotensin-converting enzyme (ACE) inhibitors and sympathectomy are equally effective in preventing arterial structural changes in hypertension,67 (2) ACE inhibitors and {alpha}1-adrenoceptor antagonists are equally effective in reducing neointima formation after balloon injury,69 70 71 and (3) treatment with {alpha}1-adrenoceptor antagonists impairs the mitogenic response of arteries to intravenously infused Ang II.72 Several types of ACE inhibitors have now been observed to reduce neointima formation after balloon injury of rat and rabbit arteries.69 73 74 In the pig and baboon, however, ACE inhibition does not prevent neointimal thickening after balloon injury.75 76 Furthermore, in humans no significant effects of ACE inhibitor treatment could be detected with respect to intima formation and the incidence of restenosis after angioplasty.77 The role of Ang II in experimental neointima formation in rat and rabbit seems to be primarily mediated by Ang II type 1 (AT1) receptors because (1) in the rat carotid artery, most (97%) angiotensin receptors have been identified as AT1 by radioligand binding78 and (2) in all but one study,79 long-term treatment with losartan (DuP 753), an AT1 receptor antagonist, reduced neointima formation40 73 80 as ACE inhibitors do. ACE inhibitors are also effective in preventing the development of high blood pressure and structural alterations in large and small arteries of SHR.81 82 83 However, reversal of SMC hypertrophy and hyperploidy in large arteries and reversal of SMC hyperplasia in small resistance-sized arteries have not been uniformly obtained.

Also, interferences with the sympathetic nervous system alter vascular structure. Infusion of an {alpha}1-adrenoceptor agonist promotes DNA synthesis and hypertrophy in the aorta of young rats but not in mesenteric resistance-sized vessels of these animals despite a hypertrophic response at this site to systemic administration of Ang II.84 On the other hand, injection of phenylephrine into adult rats results in elevated expression of proto-oncogenes but not DNA synthesis in the thoracic aorta.85 Effects of sympathectomy have been investigated more extensively (Table 4). Neonatal immunosympathectomy with anti–nerve growth factor and guanethidine prevents the development of high blood pressure in SHR and stroke-prone SHR.43 45 The accompanying structural changes differ among different artery types and between both experimental models. In normotensive animals, structural vascular effects of sympatholytic interventions differ between young and adult animals (Table 4). In this instance, either no change or a reduction of DNA synthesis has been observed in arteries of young animals.45 86 87 88 In arteries of adults, on the other hand, surgical denervation and 6-hydroxydopamine induce an increase in SMC size and ultrastructural changes compatible with increased synthetic activity.87 89 90 91 92 93 94 Thus, although sympathetic nerves seem to exert a trophic action on vascular smooth muscle during development, they may help stabilize the contractile phenotype of the SMC in the adult. The cause of this heterogeneity in time is not known but may involve, besides catecholamines, a role for sympathetic cotransmitters such as ATP and neuropeptide Y and of neurotransmitters released by peptidergic nerves. This hypothesis is strengthened by observations that effects of ganglionectomy and chemical denervation in the adult can be prevented by the administration of an adenosine agonist94 but not by exogenous norepinephrine.89 94 Furthermore, the structural effects in the adult are not mimicked by guanethidine,89 which, unlike surgery or 6-hydroxydopamine, depletes adrenergic nerve endings of catecholamines without affecting their ATP and neuropeptide Y content and without affecting the integrity of the sensory peptidergic nerves.


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Table 4. Effects of Sympathectomy on Vascular Smooth Muscle Structure

Differences Within Vessels or Intravascular Heterogeneity
Vascular structural changes differ not only among different vessel types; diverse growth-related responses have also been observed within the wall of a given vascular segment.

Cell Culture
Observations in isolated cells support the existence of intravascular heterogeneity only indirectly. Mitogenic actions of Ang II differ among the SMCs isolated from different WKY, suggesting that the tissues from which the cells were isolated were originally composed of a mixture of Ang II–responsive and –nonresponsive cells.95 Short-term pharmacological observations strengthen this possibility because fewer rat aortic SMCs can be stimulated to raise their cytoplasmic calcium concentrations by Ang II than by norepinephrine or PDGF-BB.3 4 On the other hand, although most isolated SMCs rapidly change their phenotype from a contractile to a synthetic one5 12 96 97 98 99 when seeded at low density in the presence of serum, SMC clones have recently been derived from rat pulmonary artery100 that continue to express smooth muscle {alpha}-actin, a marker of contractile SMCs. Selection of a subset of SMCs that are unable to change their phenotype may explain this finding.

Organ Culture
Unlike isolated SMCs, only a small fraction of the medial cells can be stimulated to synthesize DNA during culture of intact segments or strips of human, pig, rabbit, or rat arteries.24 31 32 33 34 35 Furthermore, this response is transient. In rat arteries, endothelium removal increases the amplitude of the stimulation but does not unmask a mitogenic response in all medial cells.24 101

Arterial Injury
The structural response of arteries to balloon injury offers the most convincing evidence of intravascular heterogeneity of a growth response. The sequence of events that ultimately leads to neointima formation can be described by a three-wave model. Within 3 days after injury, significant DNA synthesis is initiated in the otherwise quiescent media (first wave, Table 5). This is followed by SMC migration to the intima (second wave). These intimal SMCs proliferate extensively and form new layers of cells, the neointima (third wave). The amplitude and time course of the first wave resemble those observed during exposure of isolated arteries to serum in vitro. Recent findings indicate that fibroblast growth factor and heparin are involved in the first-wave response to injury.102 103 104 However, the relevance of the first wave for the ultimate structural response (neointima formation and proliferation) is limited.111 The migration of a limited number of SMCs to the intima,112 which may rely on PDGF-BB and urokinase,105 107 plays a pivotal role. Proliferation of neointimal SMCs has been suggested to depend on transforming growth factor-ß1 and PDGF-AA108 rather than on fibroblast growth factor,113 which plays a central role in medial SMC proliferation.102 103 104 In contrast, Ang II and {alpha}1-adrenoceptors have been reported to be involved in at least the first and the third waves of the response.37 38 69 70 106 Bradykinin possibly participates as well.109 110 The different control mechanisms, along with marked neointima proliferation in the absence of significant changes of media structure, are clear examples of what above has been referred to as intravascular heterogeneity.


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Table 5. Mediators Involved in the Response to Arterial Structural Injury

Hypertension
Although arterial structural changes may be causally related to the pathogenesis of both genetic and secondary hypertension, we are not aware of attempts to type and characterize possible subpopulations of SMCs that actually participate in the structural response. Especially in genetic hypertension, in which structural alterations start during development, not all SMCs may participate to the same extent. Markers of the contractile phenotype of SMCs, such as smooth muscle {alpha}-actin, desmin, and smooth muscle myosin heavy chains, do not emerge simultaneously in the aorta of developing rats.114 Thus, in young rats, at least the aorta is a mosaic of SMCs with different degrees of differentiation. Since there are indications that the degree of differentiation affects the susceptibility of SMCs to mitogens,115 116 it is attractive to hypothesize that a subset of SMCs may play a key role in arterial structural changes during the development of genetic hypertension.

Pharmacological Interventions
Most drug intervention studies lack the spatial resolution required to strengthen the occurrence of intravascular heterogeneity. In most cases, it is not clear whether the structural alteration observed during treatment is due to a direct action on the vessel wall or is a result of altered hemodynamics, nerve activity, or plasma hormone levels. However, some findings, with respect to the sympathetic nervous system, suggest intravascular diversity. The {alpha}1-adrenoceptor antagonist doxazosin reduces stimulation of DNA synthesis elicited by Ang II in injured arteries to a larger extent in the original media than in the developing neointima.117 On the other hand, effects of sympathectomy on the size and synthetic activity of SMCs in blood vessels of adult animals are restricted to the abluminal border of the media near the adventitia, where the sympathetic nerve endings are normally located.89 94


*    What Causes Heterogeneity?
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up arrowAbstract
up arrowIntroduction
up arrowVascular Heterogeneity in...
up arrowHeterogeneity of Vascular Growth...
*What Causes Heterogeneity?
down arrowSummary and Perspective
down arrowReferences
 
Although there are many examples of heterogeneity of arterial structural changes, the origin of this diversity largely remains to be established. Below we consider two possibilities.

Multifactorial Control
Whether dealing with media hypertrophy or neointima formation, it has become increasingly clear that multiple interacting stimuli are required and that the response is susceptible to autocrine and paracrine inhibitory influences.5 16 17 20 118 Examples of this are stimulation of the production of PDGF-AA and transforming growth factor-ß1 upon exposure of cultured SMCs to Ang II118 119 as well as the interaction between the renin-angiotensin and sympathetic systems, which we have stressed above. The multifactorial nature of SMC growth control is not limited to these specific examples but has also been documented for PDGF,120 epidermal growth factor,121 122 and cytokines.123 124 This raises the possibility that differences in the supply of any of the mediators involved will influence the ultimate structural outcome (Fig 2) and may thus participate in the diversity of structural responses. It will be clear that there is an exponential relationship between the number of mediators involved in growth control and the ultimate structural outcome (Fig 2).



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Figure 2. Drawing shows a cascade of vascular growth responses involving humoral growth mediators, the microenvironment, and growth mediation within the vessel. Note that every level on the cascade may have a stimulatory (+) or inhibitory (-) growth effect. The sum of these partial effects determines the final effect on vascular growth. From this drawing it is evident that the final growth effects to an initial stimulus can be diverse and range from a positive effect to no effect or even a negative effect on vascular growth.

Sources of paracrine modulators of SMC growth control are unevenly distributed throughout the vasculature. In the intact arterial wall, the components of the vascular renin-angiotensin system are unevenly distributed over periarterial adipocytes, SMCs, and endothelial cells.125 After balloon injury, angiotensinogen,126 ACE, and Ang II receptors103 are also expressed in the neointima. Local concentrations of Ang II and growth responses to the peptide thus may vary throughout the vascular wall. The density and distribution of the various types of perivascular nerves vary considerably throughout the vascular tree127 128 (Fig 3). Also, the relative importance of the endothelium-derived mediators may differ as a function of the medial thickness and the presence of vasa vasorum. Endothelium can release a broad variety of growth factors, cytokines, and growth inhibitors129 130 131 and influence the proliferation of SMCs.24 31 32 101 As nerves do, the endothelium may thus influence the mitogenic condition of the local microenvironment surrounding the SMCs.132 This is also the case for the ECM, the composition of which differs along the vascular tree, possibly as a consequence of local conditions of pulse pressure and flow.133 Various ECM components may bind growth factors and influence the phenotype of SMCs, which in turn can affect their susceptibility to mitogenic conditions.16 20 Thus, the diverse contributions of nerves, endothelium, and the ECM to the microenvironment in the arterial media may promote regional diversity of vascular responses. This is not restricted to differences among vessel types but applies to intravascular heterogeneity as well. Although the endothelium is of course primarily situated at the luminal surface of the vessel, nerves are concentrated near the border between adventitia and media. Opposite concentration gradients for endothelium-derived mediators and neurotransmitters thus exist within the vascular wall (Fig 3). This concentration gradient is more pronounced for thick-walled than for thin-walled vessels. The functional antagonism of nervous and endothelial influences has previously been proposed with respect to the control of vascular tone.127 It has been suggested that in this situation electrical conduction between SMCs tends to coordinate the response of the entire media to locally supplied bioactive agents.127 Growth control, on the other hand, has been suggested to primarily depend on enzymatic systems (such as tyrosine kinases and protein kinase C) and may therefore be more susceptible to local environmental influences than vascular contractility.



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Figure 3. Drawings show longitudinal sections through the media of the thoracic aorta (I), superior mesenteric artery (II), and one of its third- to fourth-order side branches (III) of an adult rat at normotensive in situ pressure. Drawings were aligned at the endothelium (EC) and internal elastic lamina (IEL) to highlight regional differences in media thickness and in the number of elastic laminae. Differences in the density of nerves ({bullet}, adrenergic nerve; {circ}, nonadrenergic nerve) are indicated, along with heterogeneous distribution of desmin ([dark cell profiles]; this intermediate filament protein may be a marker of smooth muscle cell phenotype or subpopulation). Open arrows indicate influence of endothelium-derived mediation; closed arrows, influence of neurotransmitters. EEL indicates external elastic lamina. (Inspired by References 1, 7, 8, 45, 52, 110, and 129 and unpublished observations.)

Diversity of SMCs
Besides the supply of multiple stimuli and inhibitors, the responsiveness of the effector cells, the SMCs, may vary locally because of the lack of appropriate receptors and enzymes. Diversity of the effector cells increases the likelihood of heterogeneity (Fig 2). SMC diversity may be a selective adaptation to the long-term presence of a specific mediator (tolerance), may be part of a more complex change in phenotype, or may result from stable differences among different SMC genotypes. Tolerance and receptor downregulation have been documented for several acutely acting vasoactive agents.1 However, whether it also applies to growth-affecting factors remains to be established. On the other hand, there is no doubt that SMC phenotype can be modulated,12 23 97 but such modulation is not required before SMC proliferation.116 The SMC phenotype is primarily defined by differential expression of contractile and cytoskeletal proteins and ultrastructurally by differences in the abundance of microfilaments, rough endoplasmic reticulum, and Golgi complexes.12 Although many examples of phenotypic modulation are available in vitro and in vivo (Table 6), the molecular control remains poorly defined. Cell density145 and, possibly related to this, ECM components146 147 seem to be involved. Phenotypic modulation may thus represent a long-term variation of the dynamic interaction of SMCs with their environment. It will be interesting to devote future research not only to the factors that influence SMC phenotype but also to the more functional aspects of this type of SMC diversity.


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Table 6. Smooth Muscle Cell Diversity: Subpopulations or Phenotypic Modulation

Irreversible differences between SMC genotypes can be another explanation for the SMC diversity (Table 6). The monoclonal origin of human atherosclerotic lesions was the first suggestive evidence for the existence of such SMC subpopulations.134 One of the contributing factors may be their embryological origin. The large arteries in the head and neck are invested with SMCs derived from the neural crest, whereas the more distal vessels are invested with SMCs of mesodermal origin.148 149 Thus, at least at the interface, one can find a heterogeneous population of neural crest– and mesoderm-derived SMCs with different properties. Recently, subpopulations of SMCs have been isolated from the uninjured rat thoracic aorta and the neointima formed after injury. The latter show stable changes in culture and express fetal genes, suggesting that they represent unique genotypes.140 141 In several instances, however, it is not clear whether the observed differences are due to changes in phenotype or to different genotypes (see Table 6).

It will be interesting to devote future research not only to the factors that influence SMC phenotype but also to the characterization of the SMC genotypes and their origin as well as the functional consequences of SMC diversity. Are there really discrete SMC subtypes, or are these the extremes of a spectrum? Are SMC subtypes solely characterized by differential expression of contractile and cytoskeletal proteins, or do they also differ with respect to production and vasoactive agents and with respect to the presence of receptors for these mediators? Are these characteristics interrelated, and if so, are they under the control of specific genes?


*    Summary and Perspective
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowVascular Heterogeneity in...
up arrowHeterogeneity of Vascular Growth...
up arrowWhat Causes Heterogeneity?
*Summary and Perspective
down arrowReferences
 
Arterial structural changes in experimental hypertension and injury are heterogeneous. As for vascular functional responses, various types and levels of heterogeneity can be discerned. The origin of the differences in structural changes is largely unclear. Two hypotheses were elaborated: (1) regional and temporal variations in the concentration of multiple growth promoters and inhibitors and (2) differences between SMC subtypes in the susceptibility to mediators. These possibilities are not mutually exclusive but may interdigitate to cause heterogeneity of SMC responses at the intervascular and intravascular levels. Future comparative studies using vessels of different vascular beds and branching order and using experimental approaches with a spatial resolution sufficient to discriminate between changes in individual cells may strengthen these hypotheses. When added to the existing information derived from culture and injury models, these hypotheses may help to better define cellular and molecular targets for the prevention and reduction of specific arterial structural changes in diseases.


*    Acknowledgments
 
This work was supported by grants from the Royal Dutch Academy of Sciences (KNAW) and the Netherlands Scientific Research Organisation (NWO).


*    References
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowVascular Heterogeneity in...
up arrowHeterogeneity of Vascular Growth...
up arrowWhat Causes Heterogeneity?
up arrowSummary and Perspective
*References
 
1. Mulvany MJ, Aalkjaer C. Structure and function of small arteries. Physiol Rev. 1990;70:921-961. [Abstract/Free Full Text]

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K. Ruijtenbeek, F. A. C. le Noble, G. M. J. Janssen, C. G. A. Kessels, G. E. Fazzi, C. E. Blanco, and J. G. R. De Mey
Chronic Hypoxia Stimulates Periarterial Sympathetic Nerve Development in Chicken Embryo
Circulation, December 5, 2000; 102(23): 2892 - 2897.
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Am. J. Physiol. Heart Circ. Physiol.Home page
A. W. van Gorp, D. S. V. I. Schenau, A. P. G. Hoeks, H. A. J. S. Boudier, J. G. R. de Mey, and R. S. Reneman
In spontaneously hypertensive rats alterations in aortic wall properties precede development of hypertension
Am J Physiol Heart Circ Physiol, April 1, 2000; 278(4): H1241 - H1247.
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Am. J. Physiol. Heart Circ. Physiol.Home page
F. A. C. le Noble, K. Ruijtenbeek, S. Gommers, J. G. R. de Mey, and C. E. Blanco
Contractile and relaxing reactivity in carotid and femoral arteries of chicken embryos
Am J Physiol Heart Circ Physiol, April 1, 2000; 278(4): H1261 - H1268.
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StrokeHome page
P. Moreau, H. Takase, L. V. d'Uscio, T. F. Luscher, and G. L. Baumbach
Effect of Chronic Nitric Oxide Deficiency on Angiotensin II–Induced Hypertrophy of Rat Basilar Artery • Editorial Comment
Stroke, May 1, 1998; 29(5): 1031 - 1036.
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Cardiovasc ResHome page
P. Moreau, L. V d'Uscio, and T. F Luscher
Structure and reactivity of small arteries in aging
Cardiovasc Res, January 1, 1998; 37(1): 247 - 253.
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Cardiovasc ResHome page
M. Adner, E. Uddman, L. O. Cardell, and L. Edvinsson
Regional variation in appearance of vascular contractile endothelin-B receptors following organ culture
Cardiovasc Res, January 1, 1998; 37(1): 254 - 262.
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Am. J. Physiol. Heart Circ. Physiol.Home page
F. Pourageaud and J. G. R. De Mey
Structural properties of rat mesenteric small arteries after 4-wk exposure to elevated or reduced blood flow
Am J Physiol Heart Circ Physiol, October 1, 1997; 273(4): H1699 - H1706.
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HypertensionHome page
D. deBlois, B.-S. Tea, T.-V. Dam, J. Tremblay, and P. Hamet
Smooth Muscle Apoptosis During Vascular Regression in Spontaneously Hypertensive Rats
Hypertension, January 1, 1997; 29(1): 340 - 344.
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Arterioscler. Thromb. Vasc. Bio.Home page
E. M. van Kleef, J. Fingerle, and M. J.A.P. Daemen
Angiotensin II-Induced Progression of Neointimal Thickening in the Balloon-Injured Rat Carotid Artery Is AT1 Receptor Mediated
Arterioscler. Thromb. Vasc. Biol., July 1, 1996; 16(7): 857 - 863.
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Arterioscler. Thromb. Vasc. Bio.Home page
S. Heeneman, P. J. A. Leenders, P. J. J. W. Aarts, J. F. M. Smits, J. W. Arends, and M. J. A. P. Daemen
Peripheral Vascular Alterations During Experimental Heart Failure in the Rat : Do They Exist?
Arterioscler. Thromb. Vasc. Biol., September 1, 1995; 15(9): 1503 - 1511.
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