Molecular insights and therapeutic targets for diabetic endothelial dysfunction

J Xu, MH Zou - Circulation, 2009 - Am Heart Assoc
Circulation, 2009Am Heart Assoc
endothelium in vascular disease has enabled the development of clinical tests to evaluate
the functional properties of normal and activated endothelium. 5 Ideally, such tests should
be safe, noninvasive, reproducible, inexpensive, and standardized between laboratories.
The results should also reflect the dynamic biology of the endothelium throughout the
natural history of atherosclerotic disease, define subclinical disease processes, and provide
prognostic information for risk stratification in the later clinical phase. 6 No single test …
endothelium in vascular disease has enabled the development of clinical tests to evaluate the functional properties of normal and activated endothelium. 5 Ideally, such tests should be safe, noninvasive, reproducible, inexpensive, and standardized between laboratories. The results should also reflect the dynamic biology of the endothelium throughout the natural history of atherosclerotic disease, define subclinical disease processes, and provide prognostic information for risk stratification in the later clinical phase. 6 No single test currently fulfills these requirements, which necessitates the use of several tests to characterize the multiple aspects of endothelial biology. Because endothelial function cannot be measured directly in humans, estimates may be obtained indirectly by measuring the endothelium-dependent vasodilation (vasoregulation), plasma levels of endothelium-derived regulatory proteins (NO, endothelium-derived hyperpolarizing factor, prostacyclin [PGI2], TXA2, and endothelin-1 [ET-1]), and possibly microalbuminuria. Additional aspects of endothelial function that can be measured are coagulation, fibrinolysis, inflammation, and angiogenesis. 7 Other vascular properties such as arterial stiffness and intima/media thickness of the carotid artery are likely only endothelium dependent in part. 8
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