Vascular endotheliitis associated with infections: Its pathogenetic role and therapeutic implication.
Vascular endotheliitis associated with infections: Its pathogenetic role and therapeutic implication.
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DOI：
10.1016/j.bcp.2022.114909
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发表时间：
2022-03
影响因子：
5.8
通讯作者：
Matsuda N
中科院分区：
文献类型：
--
作者：
Hattori Y;Hattori K;Machida T;Matsuda N
血管内皮细胞是免疫反应和炎症反应的主要参与者和调节者。血管内皮炎被认为是形成血管内表面的内皮细胞的一种宿主免疫炎症反应，与感染性病原体入侵的直接后果有关。血管内皮炎和随之而来的内皮功能障碍可能是微血管衰竭的主要决定因素，这将有利于血流灌注受损、组织缺氧和随后的器官衰竭。新的证据表明，血管内皮炎在冠状病毒病2019年(新冠肺炎)及其相关并发症的发病机制中发挥了作用。因此，血管内皮炎和由此产生的细胞因子风暴一旦启动，就会在新冠肺炎引起全身炎症和血栓形成现象，导致急性呼吸窘迫综合征和广泛的器官损害。血管内皮炎似乎也是脓毒症血管病变和凝血障碍的一个促成因素，败血症被定义为由于宿主对感染的反应失调而导致的危及生命的器官功能障碍。因此，保护血管内皮细胞和逆转血管内皮炎可能是这些与血管内皮炎相关的疾病的主要治疗目标。在这篇综述中，我们概述了包括新冠肺炎在内的感染相关炎症性疾病中血管内皮炎的病因学和病原学重要性，以及导致血管内皮炎的可能机制。我们还讨论了现在可能被认为是治疗这些疾病的潜在的基于内皮炎的治疗方式的药理药物。
Vascular endothelial cells are major participants in and regulators of immune responses and inflammation. Vascular endotheliitis is regarded as a host immune-inflammatory response of the endothelium forming the inner surface of blood vessels in association with a direct consequence of infectious pathogen invasion. Vascular endotheliitis and consequent endothelial dysfunction can be a principle determinant of microvascular failure, which would favor impaired perfusion, tissue hypoxia, and subsequent organ failure. Emerging evidence suggests the role of vascular endotheliitis in the pathogenesis of coronavirus disease 2019 (COVID-19) and its related complications. Thus, once initiated, vascular endotheliitis and resultant cytokine storm cause systemic hyperinflammation and a thrombotic phenomenon in COVID-19, leading to acute respiratory distress syndrome and widespread organ damage. Vascular endotheliitis also appears to be a contributory factor to vasculopathy and coagulopathy in sepsis that is defined as life-threatening organ dysfunction due to a dysregulated response of the host to infection. Therefore, protecting endothelial cells and reversing vascular endotheliitis may be a leading therapeutic goal for these diseases associated with vascular endotheliitis. In this review, we outline the etiological and pathogenic importance of vascular endotheliitis in infection-related inflammatory diseases, including COVID-19, and possible mechanisms leading to vascular endotheliitis. We also discuss pharmacological agents which may be now considered as potential endotheliitis-based treatment modalities for those diseases.
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