Endothelial Cell Dysfunction in Atherosclerosis and Autoimmunity

Publisher Summary Endothelium plays a fundamental role in various physiologic functions, including vasoregulation, hemostasis, inflammation, and adhesion biology. Irrespective of the nature of the stimuli (immunogenic or direct mechanical forces), the endothelium responds by up-regulating adhesion molecules and recruiting leukocytes, shifting the phenotype to procoagulant by expressing tissue factor (TF), von Willebrand factor (vWF) and/or altering vascular tone. Endothelial cells line the lumen of all blood vessels and form the interface between the blood and peripheral tissues. The role of endothelial cells was considered to be that of a gatekeeper. Passive deposition of cholesterol and its metabolites in the artery wall has been thought to be the key step in the pathophysiology of atherosclerosis. In recent years attention has shifted to the role of primary vascular injury. Although many factors cause atherosclerosis, it has become clear that endothelial cell perturbation and inflammation at the site of vascular injury plays an essential role in the initiation and progression of atherosclerotic disease.