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To initiate arterial blood vessel development, a pro-arterial signal is detected by non-specified endothelial cells. This signal causes the accumulation and activation of arterial DNA-binding proteins, so-called transcription factors, which bind to certain regions of the DNA. These regions are known as enhancers and are the on-off switches for genes. Once bound by transcription factors, these arterial enhancers then switch on transcription of arterial-specific genes.

Elsewhere in the body, non-specified endothelial cells instead detect pro-venous signals, resulting in the accumulation and activation of venous transcription factors and the activation of venous-specific genes. This process occurs throughout the body in early development. The arterial and venous cells have now switched on different genes, which results in the formation of different types of blood vessels, resulting in the complicated vascular network which keeps us all alive and healthy.