BJA Advance Access originally published online on April 30, 2004
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British Journal of Anaesthesia, 2004, Vol. 93, No. 1 105-113
© 2004 The Board of Management and Trustees of the British Journal of Anaesthesia
Physiology of the endothelium
Academic Unit of Anaesthesia & Intensive Care, School of Medicine, University of Aberdeen AB25 2ZD, Scotland UK
*Corresponding author. E-mail: n.r.webster{at}abdn.ac.uk
Abstract
In the past, the endothelium was considered to be inert, described as a ‘layer of nucleated cellophane’, with only non-reactive barrier properties, such as presentation of a non-thrombogenic surface for blood flow and guarding against pro-inflammatory insults. However, it is now becoming clear that endothelial cells actively and reactively participate in haemostasis and immune and inflammatory reactions. They regulate vascular tone via production of nitric oxide, endothelin and prostaglandins and are involved in the manifestations of atherogenesis, autoimmune diseases and infectious processes. They produce and react to various cytokines and adhesion molecules and it is now clear that they can mount anti- and pro-inflammatory and protective responses depending on environmental conditions and are key immunoreactive cells. Endothelial dysfunction or activation also contributes to a variety of disease states.
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