Endothelium,thrombosis and atherosclerosis

The endothelium constitutes a specialized organ, with unique metabolic properties. Since the introduction of in vitro culture techniques, studies on the function of endothelial cells have rapidly increased and our knowledge has been greatly enhanced. It is now established that endothelial cells can either promote hemostasis or exert antithrombotic activities. These activities are in well controlled balance. Injuries to the intimal vascular monolayer may play a role in the pathogenesis of atherosclerosis and its complications. Two types of endothelial cell injury have been described: a denuding injury, secondary to endothelial cell necrosis and desquamation, which triggers platelet/subendothelial interactions, and a non-denuding injury, which induces new endothelial properties and the loss of intimal thromboresistance. Thrombosis may complicate atherosclerosis at different stages. A role for inflammatory mediators in the pathogenesis of thrombosis has been stressed recently and this may have implications for future directions in the study of atherothrombotic disease.