Endothelial hemostasis: Thrombomodulin system and its role in pathogenesisof atherosclerosis and its complications

Over the past decade there has been an explosion of new research in the fie ld of endothelial dysfunction as a factor of development of cardiovascular diseases. Most of the studies have assessed the role the endothelium in reg ulation of vascular tone. However this is just one of many endothelial func tions. The evidence has been provided that the endothelium may also be invo lved in other functions beyond hemostasis, including cellular migration and proliferation, immune response and inflammatory reactions, angiogenesis an d vascular regeneration. Its precise role and relevance in these processes in vivo remains, however, largely unknown. Thrombomodulin, an endothelial c ell-surface receptor, plays a key modulating role in hemostatic reactions. Despite a long-term investigations of thrombomodulin system there is not en ough precise data which might determine its role in atherogenesis because o f methodic difficulties in evaluation of this system in vivo. So, in this r eview we attempted to link the alterations in thrombomodulin system with pa thogenesis of cardiovascular diseases: atherosclerosis, its risk factors an d complications. Unfortunately, at the moment there is no data concerning t he influence of standard cardiovascular therapies on the functioning of the thrombomodulin system. Further investigations in this field are of great o f importance for the better understanding of atherogenesis and development of new treatment strategies.