Endothelial cell biology: role in the inflammatory response

Human endothelial cells are multifunctional cells that line blood vessels and are capable of secreting a variety of biologically active mediators. They normally maintain vascular hemostasis and prevent thrombotic complications. When affected by infection, stress, hypertension, dyslipidemia, or high homocysteine levels, endothelial cells undergo changes resulting in "dysfunction," characterized typically by decreased endothelial expression of nitric oxide, enhanced expression of cell adhesion molecules, and associated increased binding of circulating leukocytes to these cells. There is accompanying cytokine and chemokine elaboration, resulting in cellular recruitment and the orchestration of an acute inflammatory response that can culminate in chronic inflammation if reparative mechanisms are not operative. This review will address the basic biology of endothelial cells; the expression and regulation of endothelial-derived cytokines, chemokines, and growth factors; the transcriptional regulation of these genes in endothelial cells; and the role played by these fascinating cells in human disease.