“…Among vascular cells SMC proliferation is crucial in atherogenesis, and cyclical stretching mediated by Piezo1 is commonly known to raise the SMC proliferation (Figures 3 & 4). Piezo1is crucial for sensing and transduction of mechanical cues, including shear stress [14,34] and stretching [98,110,[117][118][119][120][121], stretching was shown to work in synergy with OxLDL (oxidized lipoprotein) and norepinephrine in aggravating SMC proliferating by triggering of (ERK) signaling in both mice and rabbits [107,[122][123][124][125]. Piezo1 is necessary for shear sensing [34,126,127], and shear stress was also known to speed up and regulate SMC proliferation via several mechanisms including MMP-2, MMP-9, PDGF, and the trigger of phosphatidylinositol 3 kinase (PI3K)protein kinase B, ERK1/2, Akt signaling [128].…”