Lüscher T F, Wenzel R R, Noll G
University Hospital, Bern, Switzerland.
Eur Heart J. 1995 May;16 Suppl C:51-8. doi: 10.1093/eurheartj/16.suppl_c.51.
Coronary artery disease is the leading cause of morbidity and mortality in western countries. Its pathogenesis is unknown, but involves enhanced vasoconstriction, increased interaction of platelets and monocytes with the vessel wall, as well as proliferation, migration and extracellular matrix formation of vascular smooth muscle. The endothelium lies in a strategic anatomical position between circulating blood and vascular smooth muscle cells. This supports the concept that dysfunction of these cells significantly contributes to coronary artery disease. Besides other mediators, endothelial cells are a source of nitric oxide and endothelin. Nitric oxide is a vasodilator, an inhibitor of both platelet function and proliferation and migration of vascular smooth muscle. Endothelin is a potent vasoconstrictor that facilitates proliferation. Under pathological conditions, in particular the presence of cardiovascular risk factors, endothelial dysfunction occurs and is a major contributor to the increase in platelet vessel wall interaction, vasoconstriction and proliferation in the coronary system. Endothelium-dependent vasodilation is usually reduced and endothelium-dependent constrictor responses, as well as endothelin production, are augmented. Hence, endothelial cells are important targets and mediators of coronary artery disease.
冠状动脉疾病是西方国家发病和死亡的主要原因。其发病机制尚不清楚，但涉及血管收缩增强、血小板和单核细胞与血管壁的相互作用增加，以及血管平滑肌的增殖、迁移和细胞外基质形成。内皮细胞处于循环血液和血管平滑肌细胞之间的关键解剖位置。这支持了这样一种观点，即这些细胞的功能障碍在很大程度上导致了冠状动脉疾病。除其他介质外，内皮细胞还是一氧化氮和内皮素的来源。一氧化氮是一种血管舒张剂，是血小板功能以及血管平滑肌增殖和迁移的抑制剂。内皮素是一种强效血管收缩剂，可促进增殖。在病理条件下，尤其是存在心血管危险因素时，会发生内皮功能障碍，这是冠状动脉系统中血小板与血管壁相互作用增加、血管收缩和增殖的主要原因。内皮依赖性血管舒张通常会降低，而内皮依赖性收缩反应以及内皮素的产生会增强。因此，内皮细胞是冠状动脉疾病的重要靶点和介质。
