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The main cause of endothelial dysfunction is impaired bioavailability of nitric oxide. [ 1 ] In addition to acting as a semipermeable membrane , the endothelium is responsible for maintaining vascular tone and regulating oxidative stress by releasing mediators, such as nitric oxide, prostacyclin and endothelin , and by controlling local ...
Endothelial activation is a proinflammatory and procoagulant state of the endothelial cells lining the lumen of blood vessels. [1] It is most characterized by an increase in interactions with white blood cells (leukocytes), and it is associated with the early states of atherosclerosis and sepsis , among others. [ 2 ]
In fact, it was not until decades after Virchow's death that a consensus was reached proposing that thrombosis is the result of alterations in blood flow, vascular endothelial injury, or alterations in the constitution of the blood. Still, the modern understanding of the factors leading to embolism is similar to the description provided by Virchow.
The chronic endothelial injury hypothesis is one of two major mechanisms postulated to explain the underlying cause of atherosclerosis and coronary heart disease (CHD), the other being the lipid hypothesis. Although an ongoing debate involving connection between dietary lipids and CHD sometimes portrays the two hypotheses as being opposed, they ...
Endothelial dysfunction has also been shown to be predictive of future adverse cardiovascular events including stroke, heart disease, and is also present in inflammatory disease such as rheumatoid arthritis, diabetes, and systemic lupus erythematosus. [18] [19] Endothelial dysfunction is a result of changes in endothelial function.
Some of these risk factors are related to inflammation. "Virchow's triad" has been suggested to describe the three factors necessary for the formation of thrombosis: hemodynamic changes (blood stasis or turbulence), vessel wall (endothelial) injury/dysfunction, and; altered blood coagulation (hypercoagulability). [17] [18]
Vasodilation occurs as part of the process of inflammation, which is caused by several factors including presence of a pathogen, injury to tissues or blood vessels, and immune complexes. [7] In severe cases, inflammation can lead to sepsis or distributive shock. [11] Vasodilation is also a major component of anaphylaxis. [12]
SARS-CoV-2 is the virus that causes the disease COVID-19 and infects different cell types, but also has shown multi-organ vascular involvement. In severe cases, SARS-CoV-2 can cause endothelial dysfunction or injury. This virus-induced endothelial responses can lead to thrombosis, congestion, and microangiopathy. [12]