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A Scoping Review on Biomarkers of Endothelial Dysfunction in Small Vessel Disease: Molecular Insights from Human
Daniela Jaime Garcia1,2, Audrey Chagnot2, Joanna M Wardlaw1,2
1Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK.
Insights
Small vessel disease (SVD) involves brain microvessel dysfunction and a compromised blood-brain barrier (BBB), contributing to dementia and stroke. This review explores biochemical markers for endothelial dysfunction in SVD.
Area of Science:
- Neurology
- Vascular Biology
- Biochemistry
Background:
- Small vessel disease (SVD) is a prevalent brain disorder affecting microvessels.
- It is a significant cause of dementia, ischemic stroke, and hemorrhagic stroke.
- Endothelial dysfunction and a compromised blood-brain barrier (BBB) are implicated in SVD pathogenesis.
Purpose of the Study:
- To review molecular mechanisms of endothelial dysfunction in SVD.
- To identify biochemical markers of endothelial dysfunction in biofluids.
- To explore potential diagnostic, prognostic, and therapeutic applications.
Main Methods:
- Scoping review of clinical studies.
- Focus on molecular mechanisms of endothelial dysfunction in SVD.
- Analysis of biochemical markers in biofluids.
Main Results:
- Endothelial dysfunction and BBB compromise are key in SVD.
- Various biochemical markers (adhesion molecules, cytokines, etc.) are associated with SVD.
- These markers offer insights into disease mechanisms.
Conclusions:
- Understanding SVD's molecular basis is crucial.
- Biochemical markers can aid diagnosis and prognosis.
- Targeting endothelial dysfunction may offer therapeutic strategies.
Abstract:
Small vessel disease (SVD) is a highly prevalent disorder of the brain's microvessels and a common cause of dementia as well as ischaemic and haemorrhagic strokes. Though much about the underlying pathophysiology of SVD remains poorly understood, a wealth of recently published evidence strongly suggests a key role of microvessel endothelial dysfunction and a compromised blood-brain barrier (BBB) in the development and progression of the disease. Understanding the causes and downstream consequences associated with endothelial dysfunction in this pathological context could aid in the development of effective diagnostic and prognostic tools and provide promising avenues for potential therapeutic interventions. In this scoping review, we aim to summarise the findings from clinical studies examining the role of the molecular mechanisms underlying endothelial dysfunction in SVD, focussing on biochemical markers of endothelial dysfunction detectable in biofluids, including cell adhesion molecules, BBB transporters, cytokines/chemokines, inflammatory markers, coagulation factors, growth factors, and markers involved in the nitric oxide cascade.
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