Disturbed Flow-Enhanced Endothelial Turnover in Atherosclerosis

Endothelial dysfunction/death is an initial event for the development of atherosclerosis occurring in the areas of arteries where blood flow is disturbed. Recent data indicated that rapid turnover of endothelial cells in atherosclerosis-prone areas is followed by endothelial repair. The mechanisms of endothelial death/proliferation in these areas related to altered blood flow involve different signal pathways, for example, endoplasmic reticulum stress-X-box binding protein 1-caspase for apoptosis and vascular endothelial growth factor receptor-histone deacetylase 3-Akt for the survival. The present review aims to update the progress in endothelial turnover in response to disturbed flow and to discuss the underlining mechanisms in the development of atherosclerosis.