Vascular Remodelling and Mesenchymal Transition in Systemic Sclerosis.

Abstract:

:Fibrosis of the skin and of internal organs, autoimmunity, and vascular inflammation are hallmarks of Systemic Sclerosis (SSc). The injury and activation of endothelial cells, with hyperplasia of the intima and eventual obliteration of the vascular lumen, are early features of SSc. Reduced capillary blood flow coupled with deficient angiogenesis leads to chronic hypoxia and tissue ischemia, enforcing a positive feed-forward loop sustaining vascular remodelling, further exacerbated by extracellular matrix accumulation due to fibrosis. Despite numerous developments and a growing number of controlled clinical trials no treatment has been shown so far to alter SSc natural history, outlining the need of further investigation in the molecular pathways involved in the pathogenesis of the disease. We review some processes potentially involved in SSc vasculopathy, with attention to the possible effect of sustained vascular inflammation on the plasticity of vascular cells. Specifically we focus on mesenchymal transition, a key phenomenon in the cardiac and vascular development as well as in the remodelling of injured vessels. Recent work supports the role of transforming growth factor-beta, Wnt, and Notch signaling in these processes. Importantly, endothelial-mesenchymal transition may be reversible, possibly offering novel cues for treatment.

journal_name

Stem Cells Int

journal_title

Stem cells international

authors

Nicolosi PA,Tombetti E,Maugeri N,Rovere-Querini P,Brunelli S,Manfredi AA

doi

10.1155/2016/4636859

subject

Has Abstract

pub_date

2016-01-01 00:00:00

pages

4636859

eissn

1687-966X

issn

1687-9678

journal_volume

2016

pub_type

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