Goal 2: Reduce Human Disease

What are the fundamental molecular mechanisms involved in the vascular response to interventional or surgical injuries?

The pathobiology of restenosis is intimal hyperplasia, a specific form of wound healing. This response to physical injury is essential to prevent hemorrhage and thus has evolved to be highly sensitive, intense, resilient and redundant. It involves a complex interplay between blood elements, endothelial integrity, leukocytes, macrophages, fibroblasts and smooth muscle cells. Modifying this multipronged response has proven elusive, with many transient claims of success. Too often clinical application has proceeded without adequate understanding of the mechanisms involved. Extraordinary human and financial costs have resulted with dramatic findings decades later, for example, that stents for stable chronic CAD are ineffective.

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Idea No. 609