K. Owen

1960). - This condition in man parallels experimental hypertension produced in animals by clamping the renal artery (Goldblatt et al., 1934). Renal-artery stenosis is now being recognized with increasing frequency in patients with high blood-pressure, and strict diagnostic criteria must be applied if successful surgical treatment is to be achieved. The diagnosis of renal-artery stenosis based upon inadequate data is likely only to lead to therapeutic failure and to bring the surgical methods employed into disrepute. Certain patients with renal- artery lesions and severe hypertension may be greatly improved by appropriate surgical procedures. It is, however, important that overenthusiastic investigation and treatment shall not result in unnecessary morbidity.

In this paper we present the results obtained in 20 patients with terminal renal failure treated by immunosuppression and cadaveric renal transplantation. Eight of these patients were still alive and well on 1 August 1965. An earlier series of 18 transplants performed here has already been reported (Porter et al., 1963, 1964).

Arteriosclerosis is an important age-dependent disease that encompasses atherosclerosis, in-stent restenosis (ISR), pulmonary hypertension, autologous bypass grafting and transplant arteriosclerosis. Endothelial dysfunction and the proliferation of vascular smooth muscle cell (vSMC)-like cells is a critical event in the pathology of arteriosclerotic disease leading to intimal-medial thickening (IMT), lipid retention and vessel remodelling. An important aspect in guiding clinical decision-making is the detection of biomarkers of subclinical arteriosclerosis and early cardiovascular risk. Crucially, relevant biomarkers need to be good indicators of injury which change in their circulating concentrations or structure, signalling functional disturbances. Extracellular vesicles (EVs) are nanosized membraneous vesicles secreted by cells that contain numerous bioactive molecules and act as a means of intercellular communication between different cell populations to maintain tissue homeostasis, gene regulation in recipient cells and the adaptive response to stress. This review will focus on the emerging field of EV research in cardiovascular disease (CVD) and discuss how key EV signatures in liquid biopsies may act as early pathological indicators of adaptive lesion formation and arteriosclerotic disease progression. EV profiling has the potential to provide important clinical information to complement current cardiovascular diagnostic platforms that indicate or predict myocardial injury. Finally, the development of fitting devices to enable rapid and/or high-throughput exosomal analysis that require adapted processing procedures will be evaluated.