Insights on aortic aneurysm and dissection: Role of the extracellular environment in vascular homeostasis

Aortic aneurysm and dissection (AAD) is a life-threatening medical condition associated with high morbidity and mortality rates. Important mechanisms underlying AAD are the dysregulation of vascular homeostasis and adverse remodeling. Vascular homeostasis maintains normal physiological function. Various physical, chemical, biological, and other internal or external environmental changes dysregulate vascular homeostasis, leading to vascular degeneration and aggravated aortic injury. This process is dependent on the communication between homeostatic mechanisms and the extracellular environment, such as local inflammatory cytokines, vasoactive substances, and hemodynamics. In this article, we summarize recent reports by Chinese researchers who studied the pathogenic mechanisms of AAD mainly from the perspective of communication of the extracellular environment with vascular homeostasis and improving diagnostic methods and therapeutic options for patients with AAD. This review aims to provide a roadmap for AAD that encompasses its pathogenesis and clinical aspects. We hope to facilitate future studies on the development of effective treatments and preventive therapies, and thus improve patient outcomes.