Disturbed acid-base transport across the plasma membrane affects intracellular pH control and has been shown--primarily based on studies with non-vascular cells--to interfere with a number of fundamental cell functions including cell migration, growth and proliferation. Here, we evaluate the effects of acid-base transport and intracellular pH on the morphology of the resistance artery wall, which is altered in a number of physiological and pathological conditions and is an independent predictor of cardiovascular risk. The current evidence supports that disturbed function and/or expression of acid-base transporters can alter resistance artery morphology--and potentially atherosclerosis-prone conduit arteries--and hence should be considered as possible mechanistic components and targets for treatment in cardiovascular disease. More experimental evidence is required, however, to evaluate the cell biological effects of acid-base transport in vascular cells, the roles of specific acid-base transporters in artery remodeling, the relative mechanistic importance of acid-base transporters in the vascular wall compared to other organs, and the therapeutic potential of modifying acid-base transport activity pharmacologically or genetically.
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