Department of Biomedical Engineering, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.
Department of Engineering and Applied Sciences, University of Bergamo, Dalmine, Italy.
Int J Artif Organs. 2024 Aug;47(8):590-601. doi: 10.1177/03913988241268105. Epub 2024 Aug 21.
Mechanical forces related to blood pressure and flow patterns play a crucial role in vascular homeostasis. Perturbations in vascular stresses and strain resulting from changes in hemodynamic may occur in pathological conditions, leading to vascular dysfunction as well as in vascular prosthesis, arteriovenous shunt for hemodialysis and in mechanical circulation support. Turbulent-like blood flows can induce high-frequency vibrations of the vessel wall, and this stimulus has recently gained attention as potential contributors to vascular pathologies, such as development of intimal hyperplasia in arteriovenous fistula for hemodialysis. However, the biological response of vascular cells to this stimulus remains incompletely understood. This review provides an analysis of the existing literature concerning the impact of high-frequency stimuli on vascular cell morphology, function, and gene expression. Morphological and functional investigations reveal that vascular cells stimulated at frequencies higher than the normal heart rate exhibit alterations in cell shape, alignment, and proliferation, potentially leading to vessel remodeling. Furthermore, vibrations modulate endothelial and smooth muscle cells gene expression, affecting pathways related to inflammation, oxidative stress, and muscle hypertrophy. Understanding the effects of high-frequency vibrations on vascular cells is essential for unraveling the mechanisms underlying vascular diseases and identifying potential therapeutic targets. Nevertheless, there are still gaps in our understanding of the molecular pathways governing these cellular responses. Further research is necessary to elucidate these mechanisms and their therapeutic implications for vascular diseases.
血流动力学变化引起的血压和流场变化所产生的机械力在血管稳态中起着至关重要的作用。在病理条件下，血管壁应力和应变的改变可能导致血管功能障碍，这在血管假体、血液透析用动静脉分流和机械循环支持中都有体现。类似湍流的血流会引起血管壁的高频振动，这种刺激最近作为血管病变的潜在因素引起了关注，例如血液透析用动静脉瘘内内膜增生的发展。然而，血管细胞对这种刺激的生物学反应仍不完全清楚。这篇综述分析了关于高频刺激对血管细胞形态、功能和基因表达影响的现有文献。形态学和功能学研究表明，在高于正常心率的频率下刺激血管细胞会导致细胞形状、排列和增殖的改变，可能导致血管重塑。此外，振动调节内皮和平滑肌细胞的基因表达，影响与炎症、氧化应激和肌肉肥大相关的途径。了解高频振动对血管细胞的影响对于揭示血管疾病的机制和确定潜在的治疗靶点至关重要。然而，我们对这些细胞反应的分子途径的理解仍然存在差距。需要进一步的研究来阐明这些机制及其在血管疾病治疗中的意义。
