Regulation of Endothelial Activation and Vascular Inflammation by Shear Stress

Atherosclerosis is a multifactorial disorder caused by genetic and environmental factors such as cholesterol, obesity, hypertension, diabetes, and smoking and is the primary cause of morbidity and mortality worldwide. Blood flow is known to exert shear stress on the vascular endothelium. Atherosclerotic lesions occur predominantly at sites of low shear, whereas regions of the vasculature exposed to high shear are protected. Low shear stress leads to activation of endothelial cells which in turn can initiate inflammation. Shear stress can also modulate several signalling pathways mediated by the activated endothelial cells. The molecules involved in these signalling pathways can be atheroprotective or atherogenic. The aim of this chapter is to discuss the effects of low shear stress on the regulation of endothelial activation and subsequent vascular inflammation.