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BRS Phase 1b > Vascular Endothelium in Cardiovascular disease > Flashcards

Vascular Endothelium in Cardiovascular disease Flashcards

1
Q

Where do most endothelial cells reside?

A

98% of all endothelial cells reside within the microvasculature.

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2
Q

What are the 3 layers of blood vessels?

A

Tunica adventitia - Vasa vasorum ,nerves
Tunica Media - Smooth muscle cells
Tunica Intima - Endothelium

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3
Q

What are capillaries made up of?

A

Endothelial cells & pericytes

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4
Q

What is the role of the Microvascular Endothelium?

A

It is the source of angiocrine factors that maintain tissue homeostasis & organ regeneration.

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5
Q

What diseases can dysfunctional endothelium contribute to ?

A

Ischemia
Chronic inflammatory disease
Cancer
Diabetes

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6
Q

What are organotypic properties?

A

Endothelial cells have tissue specific properties & expression profiles. Heterogenous.

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7
Q

How deep are endothelial cells?

A

Monolayer - 1 cell deep

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8
Q

What is the role of the endothelium?

A

Barrier separating blood from tissues
Very extensive >1000m2, >100g
Very flat cells

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9
Q

What is Contact inhibition?

A

Formation of endothelial cell junctions, resulting in cells saying to each other stop growing.

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10
Q

What is the life span of endothelial cells?

A

Endothelial cells have a long life & low proliferation rate, unless there is damage.

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11
Q

What are some essential functions of blood vessels controlled by endothelial cells?

A 
Vascular tone
Aniogenesis
Haemostasis & thrombosis
Permeability
Inflammation
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12
Q

What is Angiogenesis?

A

Formation of new blood vessels.

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13
Q

What pathways are activated when endothelial cells are resting?

A

Anti-Inflammatory
Anti-thrombotic
Anti-proliferative

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14
Q

What pathways are activated when endothelial cells are activated?

A

Pro-inflammatory
Pro thrombotic
Pro-Angiogenic

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15
Q

What triggers chronic activation of the endothelium?

A 
Smoking
Viruses
Mechanical stress
Inflammation
High Blood pressure
OxDl
High Glucose
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16
Q

What does Chronic activation of the endothelium result in over time?

A 
Thrombosis
Senescence
Permeability
Leukocyte recruitment
ALL contribute to the development of atherosclerosis.
17
Q

What is the Pathogenesis of Atherosclerosis?

A

Initial injury results in activation of the endothelium.
This causes an increase in; Endothelial permeability, systems which promote adhesion & migration of leukocytes. This results in leukocyte accumulation in sub-endothelial space. Phagocytosis of the lipids there causes Foam-cell formation.
Formation o an advanced complicated lesion of atherosclerosis.

18
Q

What does the formation of an advanced complicated lesion of Atherosclerosis consist of?

A

Macrophage accumulation
Formation of Necrotic core
Fibrous Cap formation
Angiogenesis

19
Q

What are some stimuli & risk factors for Endothelial cell dysfunction in Atherogenesis?

A 
Hypercholesterolaemia
Diabetes mellitus
Hypertension
Ageing
Oxidative stress
Proinflammatory cytokines
20
Q

What allows the Leukocyte adhesion cascade?

A

Inflammatory agents activate endothelium to express molecules that support this process.

21
Q

What is the difference in structure between Capillaries & Post-capillary venules?

A

PCV have more pericytes

22
Q

When does the recruitment of blood leukocytes into tissues normally take place?

A

During inflammation;

Leukocytes adhere to the endothelium of the post-capillary venules and transmigrate into tissues.

23
Q

What is different about the recruitment of blood leukocytes in atherosclerosis?

A

Leukocytes adhere to activated endothelium of large arteries and get stuck in the sub-endothelial space

24
Q

What is the role of Monocytes in Atherosclerosis?

A

Migrate into the sub-endothelial space, differentiate into macrophages and become foam cells.

25
Q

What does increased vascular permeability lead to?

A

Leakage of plasma proteins through the junctions into the sub-endothelial space.

26
Q

How does vascular permeability lead to atherosclerosis?

A

Lipoproteins come through leaky junctions and bind proteoglycans. They get oxidated in the sub-endothelial space (good environment for oxidation). Macrophages englobate Lipoproteins to form Foam cell.

27
Q

What are the three stages in the development of Atherosclerosis?

A

1 - Endothelial cell dysfunction
2 - Fatty streak Formation
3 - Atherosclerosis lesion formation

28
Q

Where do atherosclerosis plaques preferentially occur?

A

Bifurcations and curvatures of the vascular tree

29
Q

Where is blood flow laminar?

A

Straight parts of the arterial tree.

Wall shear stress is high and directional

30
Q

Where is blood flow Disturbed?

A

Branches & Curvatures.

Non-uniform & irregular distribution of low wall shear stress.

31
Q

What does Laminar blood flow promote?

A

Anti-thrombotic, anti-inflammatory factors
endothelial survival
Inhibition of SMC proliferation
Nitric oxide (NO) production

32
Q

What does Disturbed blood flow present?

A

Thrombosis, inflammation (leukocyte adhesion)
endothelial apoptosis
SMC proliferation
Loss of Nitric oxide (NO) production

33
Q

Why is NO essential for the health of the Cardiovascular system?

A 
It;
Dilates blood vessels
Inhibits monocyte adhesion
Reduces platelet activation
Reduces proliferation of SMC in the vessel wall
Reduces release of superoxide radicals
Reduces oxidation of LDL Cholesterol
34
Q

What is Angiogenesis essential for?

A

Embryonic development
Menstrual cycle
Wound Healing

35
Q

Why is Angiogenesis two-faced?

A

It promotes plaque growth but prevents damage post iscchaemia.

36
Q

What are circulating endothelial cells a marker of in Covid-19?

A

Severe injury, levels can be corrected by anticoagulation. Covid has been proposed as a disease of endothelial cell dysfunction

37
Q

What leads to thromboinflammation?

A

loss of the normal antithrombotic and anti-inflammatory functions of endothelial cells causes thrombosis with associated inflammation.

38
Q

What is the cascade between covid infection and Procoagulation?

A

Covid infection
Cytokine storm
Endothelial activation
Procoagulant switch

BRS Phase 1b (80 decks)

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