Regulation and dysfunction of endothelium-dependant vasomotricity: applications in clinical practice

Functions of the endothelium: The endothelium plays a pivotal role in regul ating vasomotor tone, vessel permeability, blood cell extravasation, and an tiatherogenic, antithrombogenic and antiadhesive processes. Dysfunction of the endothelium: Demonstrated, in particular, by endothelium -dependent vasomotricity disorders, endothelium dysfnction occurs in many p sysiological and pathological situations that lead to atherosclerosis: adva nced age, menopause, high blood pressure, dyslipidemia, diabetes, smoking, elevated homocysteinemia, chronic renal failure... These dysfunctions of th e endothelium constitute the fundamental and very early step in the develop ment of atherosclerosis. Prevention: Specific treatment of functional anomalies of the endothelium c an be an essential element in the prevention of atherosclerosis. In certain cases, he cause of endothelial dysfuction may be related to the presence o f radical oxygen species, nitric oxide inhibitors, or increased synthesis o r release of endothelin. Potential treatments should be adapted to the spec ific cause of the underlying endothelial anomaly: antioxidants, statins, an ti-endothelins, or converting enzyme inhibitors. In clinical practice, it m ay be important to recognize the cause of endothelial dysfunction for adapt ed early drug therapy.