Reprogrammed glucose metabolism in vascular smooth muscle cells and its implications for vascular diseases

Vascular smooth muscle cells (VSMCs) play a pivotal role in maintaining vascular homeostasis and are critical contributors to the pathogenesis of various vascular diseases, including atherosclerosis, calcification, aneurysms, and pulmonary hypertension. Emerging evidence highlights the significance of glucose metabolism in regulating VSMC phenotypic transitions during these pathologies. This review provides a comprehensive overview of the major glucose metabolic pathways in VSMCs, glycolysis, the pentose phosphate pathway (PPP), and the hexosamine biosynthetic pathway (HBP), and their roles in disease development. We summarize the molecular mechanisms linking glucose metabolic reprogramming to VSMC dysfunction, focusing on key regulatory enzymes and signaling pathways. Additionally, we discuss the translational potential of targeting glucose metabolism in VSMCs for therapeutic intervention and the challenges associated with this approach. By underscoring the metabolic shifts underlying VSMC pathophysiology, this review aims to advocate further research into VSMC glucose metabolism as a promising avenue for novel vascular disease treatments.