From the Section of Athero & Lipo, Department of Medicine, Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX (X.P., L.X.).
University of Arkansas for Medical Sciences, Little Rock (C.P.).
Circ Res. 2018 Aug 3;123(4):477-494. doi: 10.1161/CIRCRESAHA.118.313237.
Our understanding of the role of the vascular endothelium has evolved over the past 2 decades, with the recognition that it is a dynamically regulated organ and that it plays a nodal role in a variety of physiological and pathological processes. Endothelial cells (ECs) are not only a barrier between the circulation and peripheral tissues, but also actively regulate vascular tone, blood flow, and platelet function. Dysregulation of ECs contributes to pathological conditions such as vascular inflammation, atherosclerosis, hypertension, cardiomyopathy, retinopathy, neuropathy, and cancer. The close anatomic relationship between vascular endothelium and highly vascularized metabolic organs/tissues suggests that the crosstalk between ECs and these organs is vital for both vascular and metabolic homeostasis. Numerous reports support that hyperlipidemia, hyperglycemia, and other metabolic stresses result in endothelial dysfunction and vascular complications. However, how ECs may regulate metabolic homeostasis remains poorly understood. Emerging data suggest that the vascular endothelium plays an unexpected role in the regulation of metabolic homeostasis and that endothelial dysregulation directly contributes to the development of metabolic disorders. Here, we review recent studies about the pivotal role of ECs in glucose and lipid homeostasis. In particular, we introduce the concept that the endothelium adjusts its barrier function to control the transendothelial transport of fatty acids, lipoproteins, LPLs (lipoprotein lipases), glucose, and insulin. In addition, we summarize reports that ECs communicate with metabolic cells through EC-secreted factors and we discuss how endothelial dysregulation contributes directly to the development of obesity, insulin resistance, dyslipidemia, diabetes mellitus, cognitive defects, and fatty liver disease.
在过去的 20 年中，我们对血管内皮细胞作用的理解不断发展，认识到它是一个动态调节的器官，在多种生理和病理过程中起着关键作用。内皮细胞（EC）不仅是循环系统和外周组织之间的屏障，而且还积极调节血管张力、血流和血小板功能。内皮细胞功能失调会导致血管炎症、动脉粥样硬化、高血压、心肌病、视网膜病变、神经病和癌症等病理状况。血管内皮与高度血管化的代谢器官/组织之间的紧密解剖关系表明，内皮细胞与这些器官之间的串扰对于血管和代谢稳态都是至关重要的。大量报道支持高脂血症、高血糖和其他代谢应激会导致内皮功能障碍和血管并发症。然而，内皮细胞如何调节代谢稳态仍知之甚少。新出现的数据表明，血管内皮在代谢稳态的调节中起着意想不到的作用，内皮功能失调直接导致代谢紊乱的发展。在这里，我们回顾了最近关于内皮细胞在葡萄糖和脂质稳态调节中关键作用的研究。特别是，我们介绍了内皮细胞调节其屏障功能以控制脂肪酸、脂蛋白、脂蛋白脂肪酶（LPL）、葡萄糖和胰岛素的跨内皮转运的概念。此外，我们总结了内皮细胞通过内皮细胞分泌因子与代谢细胞进行通讯的报告，并讨论了内皮细胞功能失调如何直接导致肥胖、胰岛素抵抗、血脂异常、糖尿病、认知缺陷和脂肪肝疾病的发展。
