The endothelium in sepsis: source of and a target for inflammation.

OBJECTIVE To discuss a possible role of the endothelium in sepsis. DATA SOURCES Studies published in biomedical journals and our own experimental results. STUDY SELECTION Studies on endothelial mechanisms in the context of sepsis. DATA EXTRACTION AND SYNTHESIS Changes in endothelial cells on activation by inflammatory stimuli are reviewed briefly; potential mechanisms that lead to endothelial damage during sepsis are discussed. CONCLUSIONS The endothelium is a key organ involved in the pathogenesis of sepsis. Dysfunction of or injury to the endothelium may be involved in the pathogenesis of multiple organ failure and should be discriminated from activation resulting from stimulation with inflammatory stimuli. Identification of the molecular mechanisms that contribute to endothelial dysfunction or damage is likely to provide novel targets for the treatment of sepsis.