1st Department of Critical Care Medicine & Pulmonary Services, School of Medicine, National and Kapodistrian University of Athens, Evangelismos Hospital, 106 76 Athens, Greece.
2nd Department of Critical Care, School of Medicine, National and Kapodistrian University of Athens, Attikon Hospital, 124 62 Athens, Greece.
Int J Mol Sci. 2020 Nov 20;21(22):8793. doi: 10.3390/ijms21228793.
The pulmonary endothelium is a metabolically active continuous monolayer of squamous endothelial cells that internally lines blood vessels and mediates key processes involved in lung homoeostasis. Many of these processes are disrupted in acute respiratory distress syndrome (ARDS), which is marked among others by diffuse endothelial injury, intense activation of the coagulation system and increased capillary permeability. Most commonly occurring in the setting of sepsis, ARDS is a devastating illness, associated with increased morbidity and mortality and no effective pharmacological treatment. Endothelial cell damage has an important role in the pathogenesis of ARDS and several biomarkers of endothelial damage have been tested in determining prognosis. By further understanding the endothelial pathobiology, development of endothelial-specific therapeutics might arise. In this review, we will discuss the underlying pathology of endothelial dysfunction leading to ARDS and emerging therapies. Furthermore, we will present a brief overview demonstrating that endotheliopathy is an important feature of hospitalised patients with coronavirus disease-19 (COVID-19).
肺血管内皮是一层代谢活跃的扁平内皮细胞连续单层，位于血管内部，介导涉及肺内稳态的关键过程。这些过程中的许多在急性呼吸窘迫综合征（ARDS）中被破坏，ARDS 的特征是弥漫性内皮损伤、凝血系统强烈激活和毛细血管通透性增加。ARDS 最常发生在脓毒症的背景下，是一种破坏性疾病，与发病率和死亡率增加以及没有有效的药物治疗有关。内皮细胞损伤在 ARDS 的发病机制中起着重要作用，已经测试了几种内皮损伤的生物标志物来确定预后。通过进一步了解内皮的病理生物学，可能会开发出针对内皮的特异性治疗方法。在这篇综述中，我们将讨论导致 ARDS 的内皮功能障碍的潜在病理学和新兴治疗方法。此外，我们将简要概述表明内皮病是住院的 COVID-19 患者的一个重要特征。
