The endothelium in sepsis: Source of and a target for inflammation

Objective: To discuss a possible role of the endothelium in sepsis, Data Sources: Studies published in biomedical journals and our own experime ntal results. Study Selection: Studies on endothelial mechanisms in the context of sepsis . Data Extraction and Synthesis: Changes in endothelial cells on activation b y inflammatory stimuli are reviewed briefly; potential mechanisms that lead to endothelial damage during sepsis are discussed. Conclusions: The endothelium is a key organ involved in the pathogenesis of sepsis, Dysfunction of or injury to the endothelium may be involved in the pathogenesis of multiple organ failure and should be discriminated from ac tivation resulting from stimulation with inflammatory stimuli. Identificati on of the molecular mechanisms that contribute to endothelial dysfunction o r damage is likely to provide novel targets for the treatment of sepsis.