Abstract: The regulation of endothelial cell morphological changes and pathophysiological functions, including proliferation, migration, senescence, apoptosis, secretion and phenotypic switch, is dependent on blood flow derived shear stress. As a monolayer lining the vascular lumen, endothelial cells’ surface harbors diverse mechanoreceptors and mechanosensitive complexes that respond to different shear stress patterns, subsequently regulating gene expression and cellular behavior via mechanotransduction pathways. In particular, laminar shear stress （LSS） induces the orderly arrangement of endothelial cells, an increase in the levels of vascular protection-related genes, and the maintenance of cellular homeostasis. Conversely, low oscillatory shear stress （OSS, also known as disturbed flow） disrupts endothelial alignment while activating inflammatory and oxidative stress pathways, ultimately inducing endothelial dysfunction. This article comprehensively reviewed the latest advances on blood flow derived shear stress-regulated endothelial cell function, providing mechanistic insights into biomechanical regulation of vascular function.

Key words: shear stress, endothelial function, atherosclerosis, mechanism research