Fluid shear stress as a regulator of gene expression in vascular cells: possible correlations with diabetic abnormalities

Diabetes mellitus is associated with increased frequency, severity and more rapid progression of cardiovascular diseases. Metabolic perturbations from hyperglycemia result in disturbed endothelium-dependent relaxation, activa tion of coagulation pathways, depressed fibrinolysis, and other abnormaliti es in vascular homeostasis. Atherosclerosis is localized mainly at areas of geometric irregularity at which blood vessels branch, curve and change dia meter, and where blood is subjected to sudden changes in velocity and/or di rection of how. Shear stress resulting from blood flow is a well known modu lator of vascular cell function. This paper presents what is currently know n regarding the molecular mechanisms responsible for signal transduction an d gene regulation in vascular cells exposed to shear stress. Considering th e importance of the hemodynamic environment of vascular cells might be vita l to increasing our understanding of diabetes. (C) 1999 Elsevier Science Ir eland Ltd. All rights reserved.