The endothelium and platelets in cardiovascular disease: potential targets for therapeutic intervention

The interaction between platelets and endothelium has been implicated in many disease processes. It is now known that platelets may be involved in the initiation of atheroma, modulate various inflammatory responses, and contribute to endothelial dysfunction, in addition to their classical role in thombosis. Indeed, various drugs targeting platelets and endothelium have been shown to be of benefit in disease states. The last few years has seen an exponential increase in our knowledge of platelet and endothelial biology. As a result of this, many new drugs, for example the ADP-antagonists and the GpIIbIIIa antagonists, have been developed for use in the clinical setting. There is also renewed interest in the use of older drugs (for example, the statins) in modulating platelet-endothelial interactions. This review focuses on the recent advances in our understanding of the interaction(s) between platelets and endothelium and how this knowledge could be manipulated for therapeutic gain.