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      Vascular smooth muscle cells in atherosclerosis

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          Abstract

          <p class="first" id="d17067459e113">Vascular smooth muscle cells (VSMCs) are a major cell type present at all stages of an atherosclerotic plaque. According to the 'response to injury' and 'vulnerable plaque' hypotheses, contractile VSMCs recruited from the media undergo phenotypic conversion to proliferative synthetic cells that generate extracellular matrix to form the fibrous cap and hence stabilize plaques. However, lineage-tracing studies have highlighted flaws in the interpretation of former studies, revealing that these studies had underestimated both the content and functions of VSMCs in plaques and have thus challenged our view on the role of VSMCs in atherosclerosis. VSMCs are more plastic than previously recognized and can adopt alternative phenotypes, including phenotypes resembling foam cells, macrophages, mesenchymal stem cells and osteochondrogenic cells, which could contribute both positively and negatively to disease progression. In this Review, we present the evidence for VSMC plasticity and summarize the roles of VSMCs and VSMC-derived cells in atherosclerotic plaque development and progression. Correct attribution and spatiotemporal resolution of clinically beneficial and detrimental processes will underpin the success of any therapeutic intervention aimed at VSMCs and their derivatives. </p>

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          Author and article information

          Journal
          Nature Reviews Cardiology
          Nat Rev Cardiol
          Springer Science and Business Media LLC
          1759-5002
          1759-5010
          June 26 2019
          Article
          10.1038/s41569-019-0227-9
          31243391
          73d19826-8e5c-42d5-8cbe-5d3f4f5ec566
          © 2019

          http://www.springer.com/tdm


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