Avtor/Urednik		Žemva, Aleš; Benca, Maja
Naslov		From endothelial dysfunction to hypertension
Prevedeni naslov		Od endotelijske disfunkcije do hipertenzije
Tip		članek
Vir		Slov Kardiol
Vol. in št.		Letnik 3, št. 2
Leto izdaje		2006
Obseg		str. 152-8
Jezik		eng
Abstrakt		By releasing a variety of relaxing and contracting factors, the endothelium regulates vascular tone and reactivity. Among these factors, nitric oxide (NO) is most frequently mentioned. NO is released in response to shear stress (produced by blood flow) and to activation of receptors. Basal generation of NO keeps the arterial circulation in an actively dilated state. NO is involved in the antiatherosclerotic properties of the endothelium, inhibiting platelet-vessel wall interaction, endothelial permeability, and proliferation of vascular smooth muscle cells. The role of other putative relaxing factors is rarely mentioned. Prostacydin and a still-unidentified endothelium-derived hyperpolarizing factor may also be involved. Soon after the discovery of endothelium-derived relaxing factors, it became clear that endothelial cells can mediate contraction as well. Endothelium-derived contracting factors include endothelin-1, thromboxane A2 and prostaglandin H2, as well as components of the renin-angiotensin system, such as angiotensin II. Endothelial dysfunction contributes to the underlying disease process of a number of conditions, including arterial hypertension, hypercholesterolemia, atherosclerosis, diabetes mellitus, congestive heart failure, and pulmonary hypertension. Endothelial dysfunction can be improved by: 1. non-pharmacological intervention (smoking cessation, exercise, low-cholesterol diet), 2. supplementation (l-arginine, antioxidants, estrogens), 3. medication (beta blockers, calcium channel bloclcers, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists).
Izvleček		Iz endotelija se sproščajo številni dejavniki, ki uravnavajo tonus in reaktivnost žil. Med njimi ima pomembno vlogo dušikov oksid (NO). Iz endotelijskih celic se NO sprošča pod vplivom strižnih sil, ki nastajajo med tokom krvi po žilah, ali če so aktivirani posebni receptorji. NO stalno nastaja in skrbi, da so arterije neprestano razširjene. Poleg tega NO ščiti žile pred aterosklerozo, ker zavira medsebojno učinkovanje trombocitov z žilno steno, preprečuje proliferacijo gladkomišičnih celic v žilni steni in vpliva na propustnost endotelija. Endotelij izloča tudi druge snovi, ki širijo žile, kot so prostaglandin in hipotetični iz endotelija izvirajoči hiperpolarizacijski faktor. Kmalu je postalo jasno, da endotelij izloča tudi snovi, ki krčijo žile. Mednje spadajo endotelin, tromboxan A2, prostaglandin H2 ter sestavine renin-angiotenzinskega sistema, kot je angiotenzin II. Endotelijslca disfunkcija je vpletena v patogenezo številnih bolezni kot so hipertenzija, hiperholesterolemija, ateroskleroza, sladkorna bolezen, srčno popuščanje in pljučna hipertenzija. Delovanje endotela lahko izboljšamo z nefarmakološkimi ukrepi (opustitev kajenja, telesna dejavnost, varovalna prehrana), nadomeščanjem t-arginina, antioksidantov in estrogenov ter z zdravili (zaviralci adrenergičnih receptorjev beta, zaviralci kalcijevih kanalčkov, zaviralci konvertaze in zaviralci angiotenzinskih receptorjev).
Deskriptorji		ENDOTHELIUM, VASCULAR HYPERTENSION NITRIC OXIDE EPOPROSTENOL ENDOTHELIN-1 ATHEROSCLEROSIS SMOKING CESSATION EXERCISE ARGININE ANTIOXIDANTS CALCIUM CHANNEL BLOCKERS