VSMCs in atherosclerosis: Implications on the role of inflammation and extracellular matrix remodelling

Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of mortality and morbidity worldwide. Lipid-lowering drugs, such as statins and proprotein convertase subtilisin/kexin type 9 inhibitors, are effective in reducing plasma low-density lipoprotein cholesterol levels and the ri...

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Main Authors: Suha Jarad, Govind Gill, Peter Amadi, Hong-mei Gu, Da-wei Zhang
Format: Article
Language:English
Published: Elsevier 2025-08-01
Series:Pharmacological Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S1043661825002580
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author Suha Jarad
Govind Gill
Peter Amadi
Hong-mei Gu
Da-wei Zhang
author_facet Suha Jarad
Govind Gill
Peter Amadi
Hong-mei Gu
Da-wei Zhang
author_sort Suha Jarad
collection DOAJ
description Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of mortality and morbidity worldwide. Lipid-lowering drugs, such as statins and proprotein convertase subtilisin/kexin type 9 inhibitors, are effective in reducing plasma low-density lipoprotein cholesterol levels and the risk of ASCVD. However, the residual risk of ASCVD remains very high. Therefore, new strategies to treat ASCVD are urgently needed. Vascular smooth muscle cells (VSMCs) are essential contributors to atherosclerosis development and progression, with more than 50 % of atherosclerotic foam cells originating from VSMCs. VSMCs are characterized by their plasticity and ability to switch phenotype in response to the changing environment of atherosclerotic lesions, starting from the early stage of intimal thickening to the most advanced atherosclerotic lesions. However, VSMCs do not act independently, they interact with neighbouring cells and respond to the surrounding growth factors and cytokines by modulating their protein expression and changing their phenotype. Therefore, the main functions of VSMCs in atherosclerosis will be influenced, including the production of extracellular matrix (ECM) proteins and the maintenance of atherosclerotic plaque stability. In this review, we summarize the current understanding of VSMCs in atherosclerosis, focusing on their origin, plasticity, phenotype switching, and role at different stages of atherosclerosis. Furthermore, we highlight the influence of growth factors and cytokines on VSMC behaviour in atherosclerosis and discuss the role of ECM remodelling, specifically by integrins and matrix metalloproteinases, on VSMCs in atherosclerosis. Finally, we focus on current therapeutic strategies and options to target VSMCs in atherosclerosis management.
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spelling doaj-art-f331f6be71c14cd39628d1f8babe5fed2025-08-20T02:45:42ZengElsevierPharmacological Research1096-11862025-08-0121810783310.1016/j.phrs.2025.107833VSMCs in atherosclerosis: Implications on the role of inflammation and extracellular matrix remodellingSuha Jarad0Govind Gill1Peter Amadi2Hong-mei Gu3Da-wei Zhang4The Department of Biochemistry and Group on the Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaThe Department of Pediatrics and Group on the Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaThe Department of Pediatrics and Group on the Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaThe Department of Pediatrics and Group on the Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaThe Department of Biochemistry and Group on the Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; The Department of Pediatrics and Group on the Molecular and Cell Biology of Lipids, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; Correspondence to: Department of Pediatrics, Group on the Molecular and Cell Biology of Lipids, University of Alberta, 303 Heritage Medical Research Centre, Edmonton, AB T6R 2G3, Canada.Atherosclerotic cardiovascular disease (ASCVD) is one of the leading causes of mortality and morbidity worldwide. Lipid-lowering drugs, such as statins and proprotein convertase subtilisin/kexin type 9 inhibitors, are effective in reducing plasma low-density lipoprotein cholesterol levels and the risk of ASCVD. However, the residual risk of ASCVD remains very high. Therefore, new strategies to treat ASCVD are urgently needed. Vascular smooth muscle cells (VSMCs) are essential contributors to atherosclerosis development and progression, with more than 50 % of atherosclerotic foam cells originating from VSMCs. VSMCs are characterized by their plasticity and ability to switch phenotype in response to the changing environment of atherosclerotic lesions, starting from the early stage of intimal thickening to the most advanced atherosclerotic lesions. However, VSMCs do not act independently, they interact with neighbouring cells and respond to the surrounding growth factors and cytokines by modulating their protein expression and changing their phenotype. Therefore, the main functions of VSMCs in atherosclerosis will be influenced, including the production of extracellular matrix (ECM) proteins and the maintenance of atherosclerotic plaque stability. In this review, we summarize the current understanding of VSMCs in atherosclerosis, focusing on their origin, plasticity, phenotype switching, and role at different stages of atherosclerosis. Furthermore, we highlight the influence of growth factors and cytokines on VSMC behaviour in atherosclerosis and discuss the role of ECM remodelling, specifically by integrins and matrix metalloproteinases, on VSMCs in atherosclerosis. Finally, we focus on current therapeutic strategies and options to target VSMCs in atherosclerosis management.http://www.sciencedirect.com/science/article/pii/S1043661825002580Macrophagessmooth muscle cellscardiovascular diseaseinflammationmatrix metalloproteinasecell migration
spellingShingle Suha Jarad
Govind Gill
Peter Amadi
Hong-mei Gu
Da-wei Zhang
VSMCs in atherosclerosis: Implications on the role of inflammation and extracellular matrix remodelling
Pharmacological Research
Macrophages
smooth muscle cells
cardiovascular disease
inflammation
matrix metalloproteinase
cell migration
title VSMCs in atherosclerosis: Implications on the role of inflammation and extracellular matrix remodelling
title_full VSMCs in atherosclerosis: Implications on the role of inflammation and extracellular matrix remodelling
title_fullStr VSMCs in atherosclerosis: Implications on the role of inflammation and extracellular matrix remodelling
title_full_unstemmed VSMCs in atherosclerosis: Implications on the role of inflammation and extracellular matrix remodelling
title_short VSMCs in atherosclerosis: Implications on the role of inflammation and extracellular matrix remodelling
title_sort vsmcs in atherosclerosis implications on the role of inflammation and extracellular matrix remodelling
topic Macrophages
smooth muscle cells
cardiovascular disease
inflammation
matrix metalloproteinase
cell migration
url http://www.sciencedirect.com/science/article/pii/S1043661825002580
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