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Using En Face Immunofluorescence Staining to Observe Vascular Endothelial Cells Directly
Published on: August 20, 2019
From endothelial dysfunction to atherosclerosis
S Sitia1, L Tomasoni, F Atzeni
1IRCCS Galeazzi Orthopedic Institute, Department of Health Technologies, Università di Milano, Milan, Italy.
Insights
Endothelial dysfunction, a key factor in atherosclerosis, is linked to cardiovascular risks and immune system involvement. Understanding its genetic basis offers new approaches to cardiovascular disease.
Area of Science:
- Cardiovascular Science
- Immunology
- Genetics
Background:
- Endothelial dysfunction, marked by reduced nitric oxide bioavailability, is an early atherosclerosis stage.
- Traditional cardiovascular risk factors (dyslipidemia, hypertension, hyperglycemia, diabetes) and factors like oxidized LDLs contribute to its pathogenesis.
- The immune system, particularly autoimmunity, plays a significant role in endothelial dysfunction and atherosclerosis development.
Purpose of the Study:
- To review the pathogenesis and development of endothelial dysfunction.
- To highlight the role of traditional cardiovascular risk factors and immune system involvement.
- To discuss the utility of vasoreactivity tests and the future potential of genetic studies.
Main Methods:
- Review of current literature on endothelial dysfunction and atherosclerosis.
- Discussion of traditional cardiovascular risk factors and their impact on endothelial function.
- Exploration of immune system's role, including autoimmunity and systemic autoimmune diseases.
- Evaluation of vasoreactivity tests (e.g., flow-mediated dilation) and coronary microvascular dysfunction assessment (e.g., echocardiography).
- Consideration of genetic factors in endothelial damage.
Main Results:
- Endothelial dysfunction is strongly associated with traditional cardiovascular risk factors.
- Oxidized low-density lipoproteins, renin-angiotensin axis, and insulin resistance are key pathogenetic factors.
- Immune system activation and autoimmunity are increasingly recognized in endothelial dysfunction and atherosclerosis.
- Vasoreactivity tests and coronary microvascular function assessments can detect preclinical impairment.
- Genetic underpinnings of endothelial damage offer potential for improved cardiovascular disease management.
Conclusions:
- Endothelial dysfunction is a central mechanism in atherosclerosis, influenced by cardiovascular risk factors and immune pathways.
- Non-invasive tests and genetic insights are crucial for early detection and personalized treatment of cardiovascular diseases.
- Further research into the genetic basis and immune mechanisms of endothelial dysfunction is warranted for advancing cardiovascular medicine.
Abstract:
It has recently emerged that endothelial dysfunction is an early step in the development of atherosclerosis and is mainly characterised by a reduction in the bioavailability of nitric oxide. All of the traditional cardiovascular (CV) risk factors (dyslipidemia, arterial hypertension, hyperglycemia and diabetes) are associated with endothelial dysfunction, and oxidised low-density lipoproteins, the renin-angiotensin axis and insulin resistance play important roles in the pathogenesis of impaired endothelial function. The increased expression of adhesion molecules and pro-inflammatory cytokines leads to abnormal endothelium-dependent vasodilation which could be investigated using vasoreactivity tests such as flow-mediated dilation in the brachial artery. Recently, new evidences showed that the immune system plays an important role in the pathogenesis of endothelial dysfunction and atherosclerosis with a particular regard towards autoimmunity. The high prevalence of the atherosclerotic process in systemic autoimmune diseases supports the hypothesis of the immune pathogenesis. Evaluating coronary microvascular dysfunction by means of transthoracic echocardiography with non-invasive coronary flow reserve assessment is particularly interesting as it could detect preclinical impairment of coronary microvascular function. The discovery that the mechanisms responsible for endothelial damage have a genetic basis could improve the approach to CV diseases. This review summarises the most important aspects of the pathogenesis and development of endothelial dysfunction, with particular attention to the role of traditional CV risk factors, the usefulness of vasoreactivity tests, and the future perspectives opened by genetic studies.
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