The Implications of Human Stem Cell Differentiation to Endothelial Cell Via Fluid Shear Stress in Cardiovascular Regenerative Medicine: A Review

Abstract

Stem cell therapy heralds a new chapter in cardiovascular regenerative medicine. Cardiovascular implants are often used in both surgery and interventional cardiology. Cardiovascular stents are utilized in percutaneous coronary interventions (PCI), and are classified as either bare metal stents (BMS) or drug-eluting stents (DES). Although DES might decrease the risk of vascular restenosis, there are complications (e.g. thrombosis) associated with it as well. Many new and novel composite materials are increasingly being developed along the premise of mobilizing and attracting endogenous stem cells to home-in and differentiate into a confluent layer of endothelial cell around the vessel wall. One of the main forces acting on cells in a blood vessel wall is fluid shear stress. Fluid shear stress is vital in establishing the vasculature of the embryo, and different shear stress patterns have been both implicated in maintaining vascular physiology, and also associated with certain pathological conditions. Recent evidence suggests that via a plethora of mechanosensors and mechanotransduction signaling pathways, stem cells differentiate into endothelial cells when exposed to fluid shear stress. Here we review the current knowledge pertaining to the roles that mechanosensors and mechanotransducers play in stem cell differentiation into endothelial cells via fluid shear stress, and its implications for pharmacological applications and cardiovascular implants in the realm of regenerative medicine.

An Anti-CD34 Antibody-Functionalized Clinical-Grade POSS-PCU Nanocomposite Polymer for Cardiovascular Stent Coating Applications: A Preliminary Assessment of Endothelial Progenitor Cell Capture and Hemocompatibility

“…Evidence suggests that cells grown in 3D perfused reactors might be more representative of physiological conditions compared to 2D static conditions. Furthermore, it has been shown that fluid shear stress can influence the differentiation of progenitor cells into endothelial cells [62]. Therefore, a dynamic flow circuit calibrated to physiological conditions might serve as a better approximation in studying the growth and proliferation of EPCs into ECs.…”

Ex Vivo Reconstitution of Arterial Endothelium by Embryonic Stem Cell-Derived Endothelial Progenitor Cells in Baboons

“…There is increasing evidence that stem cells are capable of differentiating and proliferating if only they reside in their appropriate niches [52,53]; the regulation, survival, proliferation, and differentiation of stem cells is ultimately determined by a combination of factors intrinsic to the stem cells themselves and extrinsic signals received from the microenvironment [19][20][21][22][23][24]. Organ-specific regulators, other as-yet-unrecongnized factors and matrix components are essential for functional incorporation of transplanted cells [18].…”

Endothelial progenitor cells in atherosclerosis

“…A recent review (152) summarizes that new adult blood vessel formation is primarily due to sprouting and replication of ECs from existing local blood vessels, but is stimulated and facilitated by the prior arrival of blood-derived monocytic EPCs. Via a plethora of mechanosensors and mechanotransduction signaling pathways, stem cells differentiate into endothelial cells when exposed to fluid shear stress (153). The cited evidence suggest that a fraction of the new ECs may be BM-derived, presumably from the rare CD34+CD14-circulating cells.…”