“…NO inhibits SMC proliferation through the extracellular signal-regulated kinase (ERK) pathway leading to increased protein levels of the cyclin-dependent kinase inhibitor p21 Waf1/Cip1 [ 96 ]. cGMP-dependent protein kinase (PKG) overexpression in synthetic SMC results in phenotypic switching of SMC to a contractile phenotype that expresses contractile markers [ 97 ] (SM-MHC, calponin, α-SM actin) with reduced expression of synthetic phenotype markers (osteopontin, thrombospondin) [ 98 , 99 , 100 , 101 ]. Despite the continuous production of NO through the process of arteriogenesis, the effect of NO on SMC phenotype is not predominant in the next stages of arteriogenesis and is overridden by other factors such as cytokines, growth factors, and the increase of circumferential wall tension.…”