Abstract
Atherosclerosis occurs as a result of organized processes that include vascular endothelial dysfunction, lipid accumulation, abnormal inflammatory reaction, excessive reactive oxygen species production, and vascular cell proliferation and migration. In patients with atherosclerosis, vascular endothelial dysfunction is commonly observed with the damage of vascular endothelial glycocalyx, which is an extracellular matrix bound to and encapsulating the endothelial cells that line the blood vessel wall. Unhealthy lifestyle choices such as smoking and physical inactivity also induce glycocalyx degradation. Additionally, vascular endothelial glycocalyx can be damaged by various pathological conditions including dehydration, acute infectious disease, trauma, sepsis, acute respiratory distress syndrome, Kawasaki disease, preeclampsia, gestational diabetes mellitus, hypertension, diabetes mellitus, chronic kidney disease, atherosclerosis, stroke, dementia, microvascular angina, acute coronary syndrome, and heart failure. Vascular endothelial glycocalyx has been shown to be important as a physical cytoprotective barrier for vascular endothelial cells and as a regulatory mechanism for intracellular cell signaling. Therefore, vascular endothelial glycocalyx has immense potential in the exploration of novel strategies for the evaluation of beneficial conditions of healthy vasculature.
Highlights
All the blood vessels of the body have a layer of endothelial cells
It is said that “humans grow older with blood vessels,” vascular endothelial function is an integrated index that indicates the health of blood vessels, and maintaining good vascular endothelial function benefits general health
In a healthy vascular endothelial cell covering with enough glycocalyx, the cells are well organized and have good vascular endothelial functions including production of nitric oxide (NO), anticoagulant factors, and sufficient reactive oxygen species (ROS) for vascular homeostasis (Figure 3(a))
Summary
All the blood vessels of the body have a layer of endothelial cells. Vascular endothelial cells are known to produce various physiologically active substances and are responsible for homeostasis in a healthy body. Vascular endothelial cells play various roles in the body such as in inflammation/anti-inflammation, coagulation/fibrinolysis system, and promotion/inhibition of angiogenesis, and they ensure homeostasis by regulating balances (Figure 1). Healthy vascular endothelial cells show good functional properties. Comprehensive disease management including smoking cessation and control of lifestyle-related diseases can help maintain good vascular endothelial function. Vascular endothelial function test is used as a predictor of the onset of future cardiovascular events and to determine the effectiveness of comprehensive disease management in cardiovascular medicine. It is necessary to conduct more molecular-level research to determine the exact mechanisms of vascular endothelial cell function
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