Distinctive Signs of Disease as Deterrents for the Endothelial Function: A Systematic Review

Abstract

Endothelial integrity plays a major role in homeostasis and is responsive to the numerous endogenous factors released. While its functional role in vascular tone is well described, its role in the pathophysiology of cardiovascular disease is of interest as a potential therapeutic target. We performed a systematic review to provide an overview of new therapeutic and diagnostic targets for the treatment of coronary artery disease related to endothelial dysfunction. Databases of PubMed, Ovid’s version of MEDLINE, and EMBASE were interrogated with appropriate search terms. Inclusion criteria have been met by 28 studies that were included in the final systematic review. We identified inflammation, pulmonary hypertension, diabetes mellitus and Fabry disease as pathophysiological mechanisms and explored the therapeutic options related to these conditions including medications such as Canakinumab. Endothelial dysfunction has a key role in several different pathophysiological processes which can be targeted for therapeutic options. Ongoing research should be targeted at making the transition to clinical practice. Further research is also needed on understanding the amelioration of endothelial dysfunction with the use of cardiovascular medications.

Retrospective on global pulmonary hypertension clinical trials: 1999–2021

“…Randomized clinical trials have demonstrated that PAH is a pathological condition with clinical manifestations not confined to the lungs. Substantial evidence has documented that coronary artery disease (CAD) occurs 4 times more frequently in PH than in the worldwide population unaffected by this disease, providing a plausible reason to assert a correlation between these two clinical pathological entities ( 30 , 31 ). Several non-randomized studies have observed that many signaling pathways described in PH also play a crucial role in other diseases in which vascular remodeling occurs.…”

To Gain Insights into the Pathophysiological Mechanisms of the Thrombo-Inflammatory Process in the Atherosclerotic Plaque

“…Blood clots in dialysis and ECMO circuits have been observed in COVID-19 patients despite adequate anticoagulation, in line with the definition of thromboinflammation [ 145 ]. The principal pathogenic mechanisms underlying the pathology of COVID-19 are endothelial dysfunction [ 2 , 55 , 57 , 58 , 146 , 148 , 149 ] and thromboinflammation [ 125 ]. SARS-CoV-2 infection involves the vascular endothelium, leading to endotheliitis, thrombosis, and infiltration of inflammatory cells.…”