[Endothelins. I. Physiology]

At the beginning of 1988 in Japan in a unique manner a new peptide substance derived form the endothelium was described, so far the most powerful vasoconstrictor substance-endothelin. This started an information boom which soon led to evidence of other substances of this group, naturally related substances; the detailed structure of all endothelins was established, gradually these substances were synthetized, very sensitive radioassays for their estimation were developed. Experimental and clinical work on endothelins and their effects penetrate at present all spheres of medicine and intensive work is under way, focused on their use in the treatment of diseases as widespread as hypertension, vasospastic disorders, atherosclerosis, bronchial asthma, renal failure, etc. These findings are becoming the basis of a medical sub-discipline which can be described by the term of vascular wall endocrinology. In the first part of the review the author submits information on the chemical structure, synthesis and secretion of endothelins, on their plasma levels, mechanism of intracellular action and experimental effects. In the second part the author reviews findings on the participation of endothelins in the pathogenesis of cardiovascular and renal diseases. Their role in the control of volume homeostasis and in the genesis of the preeclamptic syndrome is discussed, as well as effects on the CNS and other organs, and the author reflects on the general impact of contemporary findings on endothelins in medicine and on possibilities of their perspective practical use.