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Review
. 2024 Aug 27;25(17):9260.
doi: 10.3390/ijms25179260.

The Relevance of the Endothelium in Cardiopulmonary Disorders

Laura de la Bastida-Casero  1 , Bertha García-León  1 , Olga Tura-Ceide  2   3   4 , Eduardo Oliver  1   5   6
Affiliations
Review

The Relevance of the Endothelium in Cardiopulmonary Disorders

Laura de la Bastida-Casero et al. Int J Mol Sci. .

Abstract

The endothelium is a cell monolayer that lines vessels and separates tissues from blood flow. Endothelial cells (ECs) have a multitude of functions, including regulating blood flow and systemic perfusion through changes in vessel diameter. When an injury occurs, the endothelium is affected by altering its functions and structure, which leads to endothelial dysfunction, a characteristic of many vascular diseases. Understanding the role that the endothelium plays in pulmonary vascular and cardiopulmonary diseases, and exploring new therapeutic strategies is of utmost importance to advance clinically. Currently, there are several treatments able to improve patients' quality of life, however, none are effective nor curative. This review examines the critical role of the endothelium in the pulmonary vasculature, investigating the alterations that occur in ECs and their consequences for blood vessels and potential molecular targets to regulate its alterations. Additionally, we delve into promising non-pharmacological therapeutic strategies, such as exercise and diet. The significance of the endothelium in cardiopulmonary disorders is increasingly being recognized, making ECs a relevant target for novel therapies aimed at preserving their functional and structural integrity.

Keywords: COVID-19; acute respiratory distress syndrome; cardiopulmonary disorders; chronic obstructive pulmonary distress; endothelium; pulmonary hypertension; therapeutic strategies.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Main mechanisms of pathology in endothelium. Blood vessels are made up mainly of ECs and SMCs, which line the inside of the vessels, also covered by a layer of fibroblast that confers structure. After damage, multiple processes occur such as inflammation, increased oxidative stress, increased aerobic glycolysis in ECs, the transformation of ECs to MCs, vasoconstriction, and finally, vascular remodeling due to the proliferation of ECs and SMCs. All of this generates dysfunction of the endothelium, which reduces the amount of blood flow that can circulate through the vessels. This dysfunction is characteristic of the diseases discussed in this review. CO2: carbon dioxide; EC: endothelial cell; EndMT: endothelial mesenchymal transition; ICAM-1: intercellular adhesion molecule 1; MC: mesenchymal cell; RNS: reactive nitrogen species; ROS: reactive oxygen species; O2: oxygen; SMC: smooth muscle cell; VCAM-1: vascular cell adhesion molecule 1.
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