This Letter to the Editor is in response to comments received from Drs. Lee, Sandow, and DeMey concerning our recently published review (29). In their Letter to the Editor, Lee et al. present a series of comments regarding the mechanisms we propose contribute to the process of arteriolar remodeling. Our proposal, and the model presented, depicts vascular smooth cells as having the intrinsic ability to alter their positional relationships within the vascular wall. Furthermore, we suggest that the vessel wall may have a plasticity not previously fully appreciated. Our model is based on direct visualization of the behavior of live vascular smooth muscle cells (VSMC) within the wall of functional resistance arteries. Conceptually, we acknowledge that a full understanding of this phenomenon will encompass aspects relating to regulation of cell-cell interactions, cell-extracellular matrix (ECM) interactions, and dynamic alterations of cytoskeletal structures.


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