Endothelial dysfunction: Many ways to correct- trends that promise

Endothelium is considered as the largest endocrine organ of the human body. The biological functions of endothelium are numerous and may vary according to the size and distribution of the blood vessel. Endothelium serves and participates in highly active metabolic and regulatory function including control of primary hemostasis, platelet and leukocyte interaction with the vessel wall. Also, it interacts with the lipoprotein metabolism and presentation of histocompatibility antigens. These dynamic and intricate functions of endothelium are extremely vulnerable which forms the basis for many therapeutic goals to be achieved. A plethora of bioactive molecules have been produced by endothelium. Endothelial factors influence vascular tone, blood flow, clot deposition, clot lysis and selective phagocytic activity. Many protein growth factors, matrix supporting proteins and vasoactive substances have been produced by the endothelium. The functions of vascular endothelium are dynamic rather than fixed. Endothelial derived substances can be mutually antagonistic. Injury to the endothelium causes dysfunction. Immune complexes, lipids, angioplasty, germs, hypertension, shear stress, hypoxia, acidosis, smoking, aging, diabetes mellitus and surgery inflict injury to the endothelium. Endothelial dysfunction is a major cardiovascular factor implicated in the pathogenesis of atherosclerosis, arterial thrombosis, pulmonary hypertension, myocardial infarction, stroke and deep vein thrombosis. New groups of salvaging drugs have been introduced to overcome the consequences of endothelial dysfunction. Yet, the value of existing drug treatment cannot be condoned in conditions of endothelial dysfunction. Time is right to embark on the drugs that modulate endothelial functions to control morbidity and mortality in various cardiovascular diseases. Hopefully, future research will offer us better drugs.