lood vessels are not just tubes through which the blood passes, but are active organs with a variety of functions that maintain the homeostasis of the circulatory system. It is a well-established fact that vascular functions are controlled by biochemical mediators, including hormones, cytokines, and neurotransmitters. However, it has recently become apparent that the biomechanical forces generated by blood flow and blood pressure regulate vascular functions. Flowing blood constantly exerts a frictional force, shear stress, on the endothelial cells (ECs) lining blood vessel walls, and the ECs respond to shear stress by changing their morphology, function, and gene expression. EC responses to shear stress are thought to play a critical role in blood-flow-dependent phenomena, including angiogenesis, 1 vascular remodeling, 2 and atherosclerosis. 3 The fact that ECs respond to shear stress indicates that they have the ability to sense shear stress as a signal and transmit it into the interior of the cell. Numerous studies have been devoted to clarifying the mechanisms of shear stress mechanotransduction, and they have demonstrated that multiple signal transduction pathways are activated by shear stress through a variety of membrane molecules and cellular microdomains, including ion channels, G protein, tyrosine kinase receptors, adhesive proteins, caveolae, the cytoskeleton, the glycocalyx, and primary cilia. The mechanisms of shear stress mechanotransduction, however, are not yet fully understood. We review the literature on EC responses to shear stress and the role of their responses in the regulation of the circulatory system, and address the issues of shear stress sensing and signaling mechanisms.
EC Responses to Shear StressA considerable amount of information on EC responses to shear stress has accumulated as a result of various in vivo, ex vivo, and in vitro experiments. In vitro experiments in which cultured ECs have been subjected to controlled levels of shear stress in fluid-dynamically designed flow-loading devices, in particular, have enabled analysis of EC responses to shear stress at cellular and molecular levels. [4][5][6][7] In this section, we describe the effects of shear stress on EC morphology, function, and gene expression, and on the differentiation of immature cells, such as endothelial progenitor cells (EPCs) and embryonic stem (ES) cells, into ECs.
MorphologyWhen examined in vivo, ECs lining segments of blood vessels in which blood flow is rapid and unidirectional are spindle-shaped and aligned with their long axis parallel to the direction of blood flow, whereas ECs lining segments in which blood flow is turbulent or stagnant are much rounder in shape and do not have a uniform orientation. 8,9 Because of these findings, shear stress is thought to determine the shape and orientation of ECs. When cultured ECs have been J 2009; 73: 1983 -1992)