The emerging role of valve interstitial cell phenotypes in regulating heart valve pathobiology

Am J Pathol. 2007 Nov;171(5):1407-18. doi: 10.2353/ajpath.2007.070251. Epub 2007 Sep 6.


The study of the cellular and molecular pathogenesis of heart valve disease is an emerging area of research made possible by the availability of cultures of valve interstitial cells (VICs) and valve endothelial cells (VECs) and by the design and use of in vitro and in vivo experimental systems that model elements of valve biological and pathobiological activity. VICs are the most common cells in the valve and are distinct from other mesenchymal cell types in other organs. We present a conceptual approach to the investigation of VICs by focusing on VIC phenotype-function relationships. Our review suggests that there are five identifiable phenotypes of VICs that define the current understanding of their cellular and molecular functions. These include embryonic progenitor endothelial/mesenchymal cells, quiescent VICs (qVICs), activated VICs (aVICs), progenitor VICs (pVICs), and osteoblastic VICs (obVICs). Although these may exhibit plasticity and may convert from one form to another, compartmentalizing VIC function into distinct phenotypes is useful in bringing clarity to our understanding of VIC pathobiology. We present a conceptual model that is useful in the design and interpretation of studies on the function of an important phenotype in disease, the activated VIC. We hope this review will inspire members of the investigative pathology community to consider valve pathobiology as an exciting new frontier exploring pathogenesis and discovering new therapeutic targets in cardiovascular diseases.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cell Lineage
  • Embryonic Stem Cells / physiology
  • Endothelial Cells / physiology
  • Heart Valve Diseases / pathology*
  • Heart Valves / pathology*
  • Humans
  • Inflammation / pathology
  • Mesenchymal Stem Cells / physiology
  • Neovascularization, Pathologic / pathology
  • Neovascularization, Physiologic / physiology
  • Osteoblasts / physiology
  • Transforming Growth Factor beta / physiology


  • Transforming Growth Factor beta