The Vascular Endothelium and Human Diseases

It seems to me that the lining of our arteries is much more important in understanding stroke origin than the simplistic lower your cholesterol.
http://www.ijbs.com/v09p1057.htm

Peramaiyan Rajendran¹, Thamaraiselvan Rengarajan¹, Jayakumar Thangavel², Yutaka Nishigaki¹, Dhanapal Sakthisekaran³, Gautam Sethi⁴, Ikuo Nishigaki¹

1. NPO-International Laboratory of Biochemistry,1-166, Uchide, Nakagawa-ku, Nagoya 454-0926, Japan;
2. Department of Pharmacology and Center of Lung and Vascular Biology, University of Illinois College of Medicine, Chicago, Illinois, United States of America;
3. Department of Medical Biochemistry, Dr. ALM PG Institute of Basic Medical Sciences, University of Madras, Taramani Campus, Chennai, India 600 113;
4. Department of Pharmacology,Yong Loo Lin School of Medicine,National University Health System, 10 Medical Drive, MD11, #05-09, Clinical Research Centre, Singapore 117597.

How to cite this article:
Rajendran P, Rengarajan T, Thangavel J, Nishigaki Y, Sakthisekaran D, Sethi G, Nishigaki I. The Vascular Endothelium and Human Diseases. Int J Biol Sci 2013; 9(10):1057-1069. doi:10.7150/ijbs.7502. Available from http://www.ijbs.com/v09p1057.htm

Abstract

Alterations of endothelial cells and the vasculature play a central role in the pathogenesis of a broad spectrum of the most dreadful of human diseases, as endothelial cells have the key function of participating in the maintenance of patent and functional capillaries. The endothelium is directly involved in peripheral vascular disease, stroke, heart disease, diabetes, insulin resistance, chronic kidney failure, tumor growth, metastasis, venous thrombosis, and severe viral infectious diseases. Dysfunction of the vascular endothelium is thus a hallmark of human diseases. In this review the main endothelial abnormalities found in various human diseases such as cancer, diabetes mellitus, atherosclerosis, and viral infections are addressed.
Keywords: Endothelium, Endothelial dysfunction, Atherosclerosis, Stroke, Cancer.

INTRODUCTION

Top
INTRODUCTION
ENDOTHELIAL FUNCTIONS
ENDOTHELIAL DYSFUNCTION
PHARMACOLOGICAL REMEDIES
CONCLUSIONS
References

The endothelium was once thought of as the ''cellophane wrapper'' of the vascular tree, with no other specific functions than affording selective permeability to water and electrolytes (1). However, enormous advances since the 1980's have led to an understanding of the complex functions of this large endocrine organ. Vascular endothelial cells line the entire circulatory system, from the heart to the smallest capillaries. These cells have very distinct and unique functions that are paramount to vascular biology. These functions include fluid filtration, such as in the glomeruli of the kidneys, blood vessel tone, hemostasis, neutrophil recruitment, and hormone trafficking. Researchers in vascular biology know well that the endothelium embodies a wide range of homeostatic functions (2), with the ability to act in both sensory and effector capacities. The role of the endothelium is effected through the presence of membrane-bound receptors for numerous molecules including proteins, lipid-transporting particles, metabolites, and hormones, as well as through specific junctional proteins and receptors that govern cell-cell and cell-matrix interactions (3). Endothelial cells (EC's) also play a pivotal role in regulating blood flow. In part, this role is achieved due to the capacity of quiescent EC's to generate an active antithrombotic surface that facilitates the transit of the plasma and cellular constituents throughout the vasculature. Perturbations, such as those that may occur at sites of inflammation or high hydrodynamic shear stress, disrupt these activities and induce EC's to create a prothrombotic and antifibrinolytic microenvironment. Blood flow is also regulated, in part, through secretion and uptake of vasoactive substances by the endothelium that act in a paracrine manner to constrict and dilate specific vascular beds in response to stimuli such as endotoxin (4). The endothelium is a cell layer lining the blood luminal surface of vessels. It was until recently considered to be just a lining, but it is now realized that EC's have important functions besides merely providing a lining for vessel walls. For example, the endothelium is now known to be involved in the control of thrombosis and thrombolysis, platelet and leukocyte interaction with the vessel wall, and the regulation of vascular tone and growth of blood vessels (5).