Keeping the Balance Right: Regulator of G Protein Signaling 5 in Vascular Physiology and Pathology.

The cardiovascular system including the heart and intricate network of arteries, veins, and capillaries is essential for normal organ homeostasis and tightly controlled by G protein-coupled receptor (GPCR) signaling cascades. Imbalances of these signaling systems can manifest in cardiovascular disease. There has been a recent surge in studies on modulators of GPCR activity, so-called regulator of G protein signaling (RGS) molecules, due to their potential as pharmacological targets. Among RGS proteins, RGS5 is prominently expressed in arterial vascular smooth muscle cells (vSMC) suggesting an important role in vascular function. Although apparently dispensable for embryonic development, RGS5 has now emerged as a crucial regulator of adaptive cardiovascular processes, including remodeling of the vascular wall under stress. RGS5 has been shown to regulate signaling pathways which shape vSMC differentiation, migration, contraction, as well as tissue inflammation and fibrosis. Indeed, studies in RGS5 mutant mice have confirmed a crucial and nonredundant role as regulator of cardiac function, blood pressure homeostasis, and adult neovascularization such as angiogenesis and arteriogenesis. In response to environmental cues, RGS5 is dynamically controlled at both mRNA and protein levels. This enables direct, precise, and rapid modulation of Gαq- and Gαi-coupled GPCR signaling which also integrates receptor tyrosine kinases (RTK) and Gαs/Gα12/13-mediated GPCR signal transduction. Although RGS5's endogenous role in a spatiotemporal context is still largely unknown, its prominence in vascular tissue makes it an important molecule to study and a prime candidate for therapeutic intervention.