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The role of vascular endothelium in the pathogenesis of connective tissue disease: endothelial injury, activation, participation and response.

Vascular involvement in the pathogenesis of connective tissue diseases is well documented but poorly understood. Endothelial cell activation and injury play a central role in the disease process. The interaction of endothelium with circulating inflammatory and immune cells may trigger a series of events that include the expression of adhesion molecules and MHC antigens in association with the synthesis and release of various active peptides that have the potential for inflaming the surrounding tissues. The understanding of the nature of endothelial functional changes in the disease process may provide opportunities for intervention and prevention.