The Magical Endothelium

 

The Fantastic Brick Road

Imagine yourself walking in an old town enjoying the scene. Enjoying the fresh air and appreciating the culture. You noticed something different about the brick road. The road seems to be alive. It changes its width to accommodate travelers. The more traffic, the wider it gets, and the less traffic, the narrower it gets. When litter lands on the surface, it gets broken down by the bricks and swept away even if it is chewing gum. It is self-cleaning.

When the rain comes, the water runs off or gets absorbed. No puddles from.  Anything that can damage the surface and subsurface is also degraded and washed away. If any vehicle breaks down, the bricks send a signal, and mechanics come. Repair is done right away.  Nothing can impede the flow of traffic. No back-ups. No delay.

If a single slab gets worn out and cannot contribute, that brick gets broken down and recycled to make a new one to replace it. There are no excess bricks. Everything is just the right amount. Most of these functions are made possible by the brick stones.

These magical bricks cover all the roads in that country and result in a very efficient traffic system. Everybody and everything arrives on time 24/7, 365 days a year. Wouldn’t it be nice if that is real?

The Endothelium

The endothelium is real! That seemingly magical road system is inside the blood vessels of the human body. The endothelium is the inner lining of the blood vessels. The endothelial cells are close to each other, just like a brick road. Unlike a passive stone block, the endothelial cells are many overachievers that work all the time. The medical words for the different functions described above are vasoconstriction and vasodilatation, coagulation and anticoagulation, fibrinolysis, promotion and inhibition of growth, apoptosis, and cell proliferation and differentiation, and production of adhesion molecules to attract cells or chemotaxis that repair the lining.

Endotelijalna_ćelija
Microscopic cross-section of an artery

A high-quality, well-functioning endothelium needs a balance of all the above to do its job. Inside each endothelial cells are specialized proteins that communicate with each other and respond to the changes in the immediate surrounding environment and the whole body’s demands. The endothelium always adjusts, cleans up, maintains, and repairs. It will do everything to keep the blood flowing.

However, the endothelium can succumb to abuse. High blood sugar, high triglycerides, low HDL (dyslipidemia), hypertension, excessive visceral fats that produce inflammatory substances, and reactive oxygen species can lead to endothelial dysfunction. The disruption of the delicate balance leads to damage. The most common injury is atherosclerosis.

Note that the five most common conditions that can cause endothelial dysfunction are all components of metabolic syndrome. Smoking and aging also cause endothelial damage. Metabolic syndrome can affect all organs of the body and leads to many common noninfectious diseases. All of which can be bad enough to land you in an emergency room. Many conditions can be avoided if we take good care of our endothelium.

How to Have a Healthy Endothelium

The most common factors that can damage the endothelium are secondary to an unhealthy diet and a sedentary lifestyle. Therefore, a low carbohydrate diet, intermittent fasting, and exercise, and discontinuing smoking are inexpensive and all doable. While we cannot stop time, the right diet and physical activity can delay the aging process’s effects.

Related Readings

  1. Nitric Oxide in Medicine
  2. Reactive Oxygen Species
  3. What is Insulin Resistance?
  4. Hyperinsulinemia
  5. What is the Goal of Diabetes Treatment?
  6. I’m Only Pre-Diabetic, So I’m Still OK, Right?
  7. Prescriptions that Promote and Pharmaceuticals that Prevent Ischemic Preconditioning
References:
  1. Michael A., Guillermo G. Endothelial Cell Dysfunction and the Pathobiology of Atherosclerosis. Circ Res. 2016 Feb 19; 118(4): 620–636. doi: 10.1161/CIRCRESAHA.115.306301
  2. Van den Oever IA, Raterman HG, Nurmohamed MT, Simsek S., Endothelial dysfunction, inflammation, and apoptosis in diabetes mellitus. Mediators Inflamm. 2010;2010:792393. doi: 10.1155/2010/792393.
  3. Park KH, Park WJ. Endothelial Dysfunction: Clinical Implications in Cardiovascular Disease and Therapeutic Approaches. J Korean Med Sci. 2015 Sep;30(9):1213-25. doi: 10.3346/jkms.2015.30.9.1213. Epub 2015 Aug 13.

Photo credits

Brick Photo by Kinga Longa from Pexels
Arterial Cross section: DRosenbach at English Wikipedia

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