Konukoglu Dildar, Uzun Hafize
Cerrahpasa Medical Faculty, Department of Biochemistry, Istanbul University, Istanbul, Turkey.
Adv Exp Med Biol. 2017;956:511-540. doi: 10.1007/5584_2016_90.
In the past, endothelium was thought to be only a mechanical barrier. Today, endothelium is known to be a tissue regulating vascular tone, cell growth and the interaction between the leukocytes, thrombocytes and the vessel wall. It also synthesizes growth factors and thrombo-regulatory molecules and responds to physical and chemical signals. Even though the term "endothelial dysfunction" is generally used for deterioration of endothelium-dependent vasodilatation; the term also includes the abnormalities between endothelium and leukocytes, thrombocytes and regulatory molecules and conditions resulting in aberrant endothelium activation. Healthy endothelium is essential for cardiovascular control. Thus, it plays an important role in pathogenesis of many diseases and cardiovascular problems such as atherosclerosis, systemic and pulmonary hypertension, cardiomyopathies and vasculitides. The aim of this chapter is to explain endothelial dysfunction and the circulating molecules of endothelial cells as they become potential targets of therapeutic approach for hypertension. This chapter reviews the roles of endothelial dysfunction in hypertension by addressing (1) the nature of endothelial function, (2) mechanisms of endothelial dysfunction and its relationship with the diseases (3) also endothelial function testing (4) the role of endothelial dysfunction and hypertension and (4) the effects of antihypertensive therapeutic options on the endothelial dysfunction. In addition to these, the role of endothelial dysfunction in white coat hypertension has been discussed. The key connections between hypertension and endothelial dysfunction are vitally important for future studies to permit new interventions to be designed and released.
过去,内皮仅被认为是一种机械屏障。如今,已知内皮是一种调节血管张力、细胞生长以及白细胞、血小板与血管壁之间相互作用的组织。它还能合成生长因子和血栓调节分子,并对物理和化学信号作出反应。尽管“内皮功能障碍”这一术语通常用于指内皮依赖性血管舒张功能的恶化;但该术语也包括内皮与白细胞、血小板及调节分子之间的异常情况,以及导致内皮异常激活的状况。健康的内皮对于心血管控制至关重要。因此,它在许多疾病和心血管问题(如动脉粥样硬化、系统性和肺动脉高压、心肌病及血管炎)的发病机制中发挥着重要作用。本章的目的是解释内皮功能障碍以及内皮细胞的循环分子,因为它们成为高血压治疗方法的潜在靶点。本章通过阐述以下内容来综述内皮功能障碍在高血压中的作用:(1)内皮功能的本质,(2)内皮功能障碍的机制及其与疾病的关系,(3)内皮功能检测,(4)内皮功能障碍与高血压的作用,以及(4)抗高血压治疗方案对内皮功能障碍的影响。除此之外,还讨论了内皮功能障碍在白大衣高血压中的作用。高血压与内皮功能障碍之间的关键联系对于未来的研究至关重要,以便能够设计并推出新的干预措施。