T | Tissue wound healing: a recapitulation of embryologic genetic memory |
I | Injury – Inflammation: OSTEOATHEROITIS – OSTEOARTHRITIS |
G | Granulation tissue formation (angiogenesis) |
E | Endothelial cell activation, proliferation, migration: ANGIOGENESIS |
R | Remodeling of the AVW: initially positive outward remodeling and over time a chronically negative inward arterial remodeling (see Scar contracture). Repair. Restructure. Resolution: results, only if the chronic injurious stimuli and sensitizers are removed from the endothelial, intimal, and medial layers of the arterial vessel wall. The above 4 (R's): activate pleuripotent mesenchymal stem-cell pericytes and VSMCs to produce bone morphogenic proteins, which are also activated by (I): Injury and Inflammation with resulting inflammatory cytokines such as TNF alpha, IL-6 and decreased IL-10. |
S | Scar: contracture and negative remodeling resulting in stenosis. AVW stiffness even without ossification. |