Endothelial dysfunction

In blood vessel diseases, endothelial dysfunction is an unhealthy state of the cells that line the blood vessels (endothelium). The main cause of endothelial dysfunction is impaired bioavailability of nitric oxide.[1]

In addition to acting as a semipermeable membrane, the endothelium is responsible for maintaining vascular tone and regulating oxidative stress by releasing mediators, such as nitric oxide, prostacyclin and endothelin, and by controlling local angiotensin-II activity.[2][3]

Dysfunctional endothelium is characterized by constricted blood vessels, increased ability of chemicals to flow through blood vessel walls, blood clots, and inflammation. This pathological state is often associated with elevated levels of biomarkers such as prothrombin time, D-dimer, von Willebrand factor, fibrin degradation products, C-reactive protein (CRP), ferritin, Interleukin 6 (IL-6), and plasma creatinine. The result of this endothelial dysregulation is a cascade of harmful effects, including tightened blood vessels, small blood vessel leakage, blood clots, high levels of inflammation, and a disrupted immune response against viruses. These changes contribute to the progression of blood vessel (vascular) diseases.[4]

In a healthy state, the endothelium exhibits wider blood vessels, tightly-controlled blood vessel permeability, and anti-thrombotic and anti-inflammatory properties. This balance ensures the smooth functioning of the vascular system.[4]

  1. ^ Marchio P, Guerra-Ojeda S, Mauricio MD (2019). "Targeting Early Atherosclerosis: A Focus on Oxidative Stress and Inflammation". Oxidative Medicine and Cellular Longevity. 2019: 8563845. doi:10.1155/2019/8563845. PMC 6636482. PMID 31354915.
  2. ^ Sitia, S.; Tomasoni, L.; Atzeni, F.; Ambrosio, G.; Cordiano, C.; Catapano, A.; Tramontana, S.; Perticone, F.; Naccarato, P. (2010). "From endothelial dysfunction to atherosclerosis". Autoimmunity Reviews. 9 (12): 830–834. doi:10.1016/j.autrev.2010.07.016. PMID 20678595.
  3. ^ Flammer AJ, Anderson T, Celermajer DS, Creager MA, Deanfield J, Ganz P, Hamburg NM, Lüscher TF, Shechter M, Taddei S, Vita JA, Lerman A (Aug 2012). "The assessment of endothelial function: from research into clinical practice". Circulation. 126 (6): 753–67. doi:10.1161/circulationaha.112.093245. PMC 3427943. PMID 22869857.
  4. ^ a b Bernard, Isabelle; Limonta, Daniel; Mahal, Lara K.; Hobman, Tom C. (January 2021). "Endothelium Infection and Dysregulation by SARS-CoV-2: Evidence and Caveats in COVID-19". Viruses. 13 (1): 29. doi:10.3390/v13010029. ISSN 1999-4915. PMC 7823949. PMID 33375371.
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