{
  "abstract": "Shear stress is a critical regulator of vascular function, influencing both endothelial and smooth muscle cell behaviour. Experimental models that capture cellular crosstalk under flow are essential to elucidate mechanisms underlying vascular remodelling and restenosis.1–3 We systematically evaluated experimental studies employing endothelial–smooth muscle cell (EC– SMC) co-cultures under flow, with a focus on mechanotransductive signalling pathways and phenotypic outcomes. Fifty-five studies were identified through systematic database searches and assessed for methodological quality, experimental configuration, and mechanistic readouts. Most studies demonstrated moderate-to-high methodological quality, though there was considerable heterogeneity in flow devices, shear magnitude, and duration of exposure. Laminar shear stress consistently promoted endothelial quiescence (↑KLF2, ↑eNOS, ↓VCAM-1) and inhibited smooth muscle cell proliferation, migration, and extracellular matrix production (↓MMP-2, ↓collagen I, ↑α-SMA), mediated via conserved pathways including NO–cGMP, PDGF-BB, TGF-β/SMAD, and RhoA– ROCK. These effects were modulated by flow duration, matrix composition, and co-culture configuration. Direct comparisons with monoculture revealed greater phenotypic stability and signalling specificity in co-culture models. With some limitations, EC–SMC co-culture systems under defined shear stress conditions provide a robust in vitro platform to interrogate haemodynamic signalling and vascular cell–cell interactions. These models yield mechanistic insights relevant to restenosis and may inform translational strategies for flow-targeted vascular therapies.References Fluid shear stress suppresses ICAM-1-mediated transendothelial migration of leukocytes in coculture model. Biochemical and Biophysical Research Communications 2018;502(3):403–408. doi:10.1016/j.bbrc.2018.05.182 A biomimetic microfluidic model to study signalling between endothelial and vascular smooth muscle cells under hemodynamic conditions. Lab on a Chip 2018;18(11):1607–1620. doi:10.1039/c8lc00286j Endothelial-derived nitric oxide impacts vascular smooth muscle cell phenotypes under high wall shear stress condition. Biochemical and Biophysical Research Communications 2024;740:151005. doi:10.1016/j.bbrc.2024.151005",
  "authors": [
    {
      "affiliations": [
        "King’s College London"
      ],
      "name": "Zahraa Bhatti"
    },
    {
      "affiliations": [
        "King’s College London"
      ],
      "name": "Arsalan Wafi"
    }
  ],
  "title": "P16  Endothelial–smooth muscle cell interactions under shear stress in restenosis",
  "uid": "8f68eef3-3c5b-5866-a4ac-f581a2062dee"
}