Endothelial cells (ECs) and smooth muscle cells (SMCs) play pivotal roles
in maintaining vascular homeostasis. Their dysregulations are critical in the
pathogenesis of various disease processes such as atherosclerosis which leads to severe
cardiovascular diseases such as coronary heart disease and stroke. Vascular
regeneration serves as an effective therapeutic strategy for these diseases. The
therapeutic prospect of stem cell-based therapy, given the capacity of stem cells to
replicate, to differentiate and to directly form new blood vessels, represents the ideal
approach for vascular regeneration. The identification of adult stem/progenitor cells in
both circulating blood and on the vessel wall indicates that endogenous stem cells have
the capacity to repair injured endothelium and restore vascular homeostasis. On the
other hand, pluripotent stem cells (PSCs), which have eminent capacity for selfrenewal,
represent the ideal candidates in regenerative medicine. There are enormous
excitements surrounding the prospect of generating functional vascular cells through
activating vascular lineage differentiation of PSCs (such as embryonic stem cells
(ESCs) and induced PSCs (iPSCs)) for clinical cell therapy. Recent advances in
induced lineage conversion from fibroblasts to ECs and SMCs present another exciting
strategy in vascular regeneration. Progresses in vascular tissue engineering have further
complemented the vascular differentiation and grafting of reprogrammed vascular
lineage cells onto the sites of vessel injury, through scaffolds made with native
matrices, synthetic polymers or decellularised tissues. Finally, the progresses made in
generating more origin-specific vascular cells from patient-derived iPSCs have enabled
researchers in uncovering new insights on the molecular mechanisms underlying
various vascular diseases, as well as for drug discovery, drug screening, toxicity testing
and personalised medicine delivery. In this chapter, we will describe different strategies
and highlight the recent efforts in generating functional vascular cells from various
populations of stem and progenitor cells, their underlying molecular mechanisms, and
their roles in therapeutic vascular regeneration. With the field of regenerative medicine
moving in an accelerating pace, the prospect of using stem and progenitor cells clinically for vascular regeneration in treating vascular and ischemic diseases is on the
horizon.
Keywords: Embryonic stem cells, Endothelial cells, Induced pluripotent stem
cells, Ischemic diseases, Lineage conversion, Stem cells, Tissue engineered blood
vessels, Transdifferentiation, Vascular differentiation, Vascular progenitor cells,
Vascular regeneration, Vascular smooth muscle cells.
