Update on endothelins - biology and clinical implications

In the decade since the initial discovery and characterization of endotheli n, its biology as a powerful vasoconstrictor has been dramatically demonstr ated. Studies have clarified the existence of endothelin isoforms, complex mechanisms of biosynthesis, interaction with specific receptors, and pathog enic implications. We are on the brink of using endothelin antagonism as a clinical treatment for disease processes where endothelin plays an importan t role, including congestive heart failure and hypertension. Novel observat ions have been made about the unexpectedly profound contribution endothelin s make to normal fetal maturation, especially in cardiac and enteric develo pment.