Article ; Online: The effects of sepsis on endothelium and clinical implications.
2020 Volume 117, Issue 1, Page(s) 60–73
Abstract: Abstract: Sepsis accounts for nearly 700 000 deaths in Europe annually and is caused by an overwhelming host response to infection resulting in organ failure. The endothelium is an active contributor to sepsis and as such represents a major target for ... ...
| Abstract | Abstract: Sepsis accounts for nearly 700 000 deaths in Europe annually and is caused by an overwhelming host response to infection resulting in organ failure. The endothelium is an active contributor to sepsis and as such represents a major target for therapy. During sepsis, endothelial cells amplify the immune response and activate the coagulation system. They are both a target and source of inflammation and serve as a link between local and systemic immune responses. In response to cytokines produced by immune cells, the endothelium expresses adhesion molecules and produces vasoactive compounds, inflammatory cytokines, and chemoattractants, thus switching from an anticoagulant to procoagulant state. These responses contribute to local control of infection, but systemic activation can lead to microvascular thrombosis, capillary permeability, hypotension, tissue hypoxia, and ultimately tissue damage. This review focuses on the role of the endothelium in leucocyte adhesion and transmigration as well as production of reactive oxygen and nitrogen species, microRNAs and cytokines, formation of signalling microparticles, and disseminated intravascular coagulation. We also discuss alterations in endothelial permeability and apoptosis. Finally, we review the diagnostic potential of endothelial markers and endothelial pathways as therapeutic targets for this devastating disease. |
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| MeSH term(s) | Animals ; Anti-Inflammatory Agents/therapeutic use ; Anticoagulants/therapeutic use ; Biomarkers/metabolism ; Blood Coagulation/drug effects ; Cardiovascular Diseases/drug therapy ; Cardiovascular Diseases/immunology ; Cardiovascular Diseases/metabolism ; Cardiovascular Diseases/pathology ; Endothelial Cells/drug effects ; Endothelial Cells/immunology ; Endothelial Cells/metabolism ; Endothelial Cells/pathology ; Endothelium, Vascular/drug effects ; Endothelium, Vascular/immunology ; Endothelium, Vascular/metabolism ; Endothelium, Vascular/pathology ; Humans ; Inflammation/drug therapy ; Inflammation/immunology ; Inflammation/metabolism ; Inflammation/pathology ; Inflammation Mediators/metabolism ; Sepsis/drug therapy ; Sepsis/immunology ; Sepsis/metabolism ; Sepsis/pathology ; Signal Transduction |
| Chemical Substances | Anti-Inflammatory Agents ; Anticoagulants ; Biomarkers ; Inflammation Mediators |
| Language | English |
| Publishing date | 2020-03-27 |
| Publishing country | England |
| Document type | Journal Article ; Research Support, N.I.H., Extramural |
| ZDB-ID | 80340-6 |
| ISSN | 1755-3245 ; 0008-6363 |
| ISSN (online) | 1755-3245 |
| ISSN | 0008-6363 |
| DOI | 10.1093/cvr/cvaa070 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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