A unifying system : does the vascular endothelium have a role to play in Multi-Organ Failure following radiation exposure ?
Over the past two decades, investigators have increasingly recognized the importance of the endothelium as a central regulator of vascular and body homeostasis. The vascular endothelium is versatile and multifunctional having, in addition to its role as a selective permeability barrier, many synthetic and metabolic properties including the modulation of vascular tone and blood flow, regulation of immune and inflammatory responses, and regulation of coagulation, fibrinolysis, and thrombosis. Perturbations of endothelial structure and function result in pathological states. Following radiation exposure changes of the vasculature and more specifically that of the endothelial cells were a prominent histological finding that dates back more than a century. Since then there have been numerous studies detailing the morphological and functional changes seen in all types of vessels following irradiation of critical organ systems. This review addresses the question of how alterations in endothelial cell functions could play a critical role in mediating organ dysfunction following radiation exposure?