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. 2022 Dec 15;11(24):4060. doi: 10.3390/cells11244060

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© 2022 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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VSMCs can undergo reversible phenotypic switching in response to stimulation by various factors. The differentiated VSMCs in the tunica media are spindle-shaped, expressing abundant contractile proteins (e.g., α-smooth muscle actin (α-SMA), calponin 1 (CNN1), smooth muscle myosin heavy chain (SMMHC), and smooth muscle protein 22-α(SM22α)), and undergo negligible proliferation and migration. The dedifferentiated synthetic VSMCs are epithelioid-shaped, expressing decreased levels of contractile proteins and increased levels of synthetic proteins (e.g., osteopontin (OPN), vimentin, S100 calcium-binding protein A4(S100A4), and N-myristoyltransferase 1 (NMT1)), and they exhibit a high proliferation and migration capacity and synthesize massive amounts of extracellular matrix (ECM). VSMCs can also acquire the characteristics of other cell types, such as osteoblasts, fibroblasts, and foam cells.