Endothelial Dysfunction in Pulmonary Hypertension: Cause or Consequence?

Endothelial Dysfunction in Pulmonary Hypertension: Cause or Consequence?
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DOI:
10.3390/biomedicines9010057
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发表时间:
2021-01-09
期刊:
影响因子:
4.7
通讯作者:
Goumans MJ
Goumans MJ
中科院分区:
工程技术3区
文献类型:
--
作者:
Kurakula K;Smolders VFED;Tura-Ceide O;Jukema JW;Quax PHA;Goumans MJ

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肺动脉高压(PAH)是一种罕见、复杂和进行性疾病,其特征是肺动脉的异常重塑,导致右心室衰竭和死亡。尽管我们对PAH中异常血管重塑的原因的理解有限,但越来越多的证据表明,内皮细胞(EC)功能障碍是启动这一过程的第一个触发因素之一。EC功能障碍导致内皮中几种细胞信号传导途径的激活,导致EC、肺动脉平滑肌细胞和成纤维细胞的不受控制的增殖,并最终导致血管重塑和肺血管的闭塞。与PAH中EC功能障碍相关的其他因素是内皮细胞向间质转化、炎症、细胞凋亡和血栓形成的增加。本文就EC功能障碍在肺动脉高压及其他肺动脉高压中的作用作一综述。我们还详细阐述了在PAH中协调EC功能障碍的分子信号。了解EC功能障碍的作用和机制将揭示PAH中靶向该过程的治疗潜力。
Pulmonary arterial hypertension (PAH) is a rare, complex, and progressive disease that is characterized by the abnormal remodeling of the pulmonary arteries that leads to right ventricular failure and death. Although our understanding of the causes for abnormal vascular remodeling in PAH is limited, accumulating evidence indicates that endothelial cell (EC) dysfunction is one of the first triggers initiating this process. EC dysfunction leads to the activation of several cellular signalling pathways in the endothelium, resulting in the uncontrolled proliferation of ECs, pulmonary artery smooth muscle cells, and fibroblasts, and eventually leads to vascular remodelling and the occlusion of the pulmonary blood vessels. Other factors that are related to EC dysfunction in PAH are an increase in endothelial to mesenchymal transition, inflammation, apoptosis, and thrombus formation. In this review, we outline the latest advances on the role of EC dysfunction in PAH and other forms of pulmonary hypertension. We also elaborate on the molecular signals that orchestrate EC dysfunction in PAH. Understanding the role and mechanisms of EC dysfunction will unravel the therapeutic potential of targeting this process in PAH.
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