4. Stem and progenitor cells in the formation of the pulmonary vasculature.

The pulmonary vasculature is formed by two distinct mechanisms: vasculogenesis and angiogenesis. During vasculogenesis vessels form by de novo synthesis from cells residing within the distal mesenchyme, while in angiogenesis new vessels sprout from preexisting structures. Both processes require the activity of vascular stem/progenitor cells to differentiate and form the components of the vessel wall. In general, blood vessels are composed of two cell types, endothelial and vascular supporting cells. Isolation of these cells from the lung demonstrates remarkable heterogeneity. In part, this heterogeneity may relate to the various stem and progenitor cells involved in the formation of the pulmonary circulation. Reports indicate that multiple stem/progenitor cells, which have unique phenotypes and possess variable differentiation capacity, exist in the lung. Moreover, these cells are derived from separate tissues and contribute only to selected regions of the pulmonary circulation. In this chapter, we will summarize what is known about pulmonary vascular stem/progenitor cells, discuss their role in the development of the arterial and venous systems, and expound upon the factors limiting their study.