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See related article, pages 146–155 Once upon a time in China, the Han philosophers introduced a syncretic intellectual framework to unite various thoughts using a new theory: the law of Yin and Yang. The basic concept of the theory is that the balance of two opposite principles regulates the universe and thus all phenomena, including human health. Yin represents the moon, cold, darkness, night, black, and quiescence, whereas Yang is sun, heat, brightness, day, white, and activity. Notably, the concept underscores the interplay of two opposite forces, but not conflicts between the two. In other words, they are not simply black and white, rather, two principles interrelating, complementing and harmonizing each other. Ancient philosophers already knew that health is life in balance, but underlying mechanisms are complex. More than a millennium later, we are still attempting to answer the same questions.An exciting and provocative study by Santiago et al, published in this issue of Circulation Research , used comprehensive in vitro and in vivo approaches to demonstrate that Yin Yang 1 (YY1), a ubiquitous and dual-functional GLI-Kruppel zinc finger transcription factor, suppresses smooth muscle cell (SMC) growth.1 The authors suggest YY1 may serve as a therapeutic tool, combating neointima formation following vascular injury. Despite a relatively new face in vascular biology, investigators in other fields of medical sciences, particularly cancer biology, have extensively studied this mysterious molecule since its initial characterizations in the late 1980s to early 1990s.2 YY1 was originally discovered as a transcriptional regulator that interacts with E1A gene products, oncoproteins that activate the adeno-associated virus (AAV) P5 promoter. When E1A is present, YY1 induces transcription; its absence converts YY1 into a repressor. The YY1 gene encodes a 414 amino-acid protein with an estimated weight …

The Balance of Power: The Law of Yin and Yang in Smooth Muscle Cell Fate