Study for the pathogenesis of moyamoya disease from aspect of vascular shear stress and endothelium

We demonstrated changed extracellular matrix of vascular endothelial cells in moyamoya disease. Extracellular matrix of vascular endothelium play an impotent role in protect endotheium against vascular shear stress. Thus, in moyamoya disease, vascular endothelium could become vulnerable to vascular shear stress. Since stenotic lesions in moyamoya disease exists in region where shear stress is high, endothelial damage would be caused first, then progressive thickening the vascular intima and narrowing the vascular lumen would occur during repair process.