Endothelial cell injury: a crucial link in microcirculatory dysfunction associated with sepsis
10.5847/wjem.j.1920-8642.2025.093
- Author:
Yuhui Pan
1
Author Information
1. Department of Emergency and Critical Care Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100032, China
- Publication Type:Review
- Keywords:
Sepsis;
Endothelial cells;
Vascular permeability;
Coagulation dysfunction;
Vasomotor regulation;
Inflammatory responses;
Microcirculatory
- From:
World Journal of Emergency Medicine
2026;17(1):28-35
- CountryChina
- Language:English
-
Abstract:
BACKGROUND Sepsis is a prevalent and severe condition, with microcirculation disruptions playing a crucial role in its progression. Endothelial cell (EC) injury is the primary factor behind microcirculatory issues. This review is to outline the pathomechanism, organ heterogeneity, biomarkers, and therapeutic implications of endothelial dysfunction in sepsis, offering references and insights for the clinical management of sepsis.
METHODS: A systematic search of Web of Science and PubMed from inception to June 10, 2025, limited to English publications, was conducted. Two reviewers independently identified studies on EC injury in patients with septic microcirculatory dysfunction. Duplicate articles based on multiple search criteria were excluded.
RESULTS: Fifty-nine articles, including cell, animal, and clinical studies, were included. These studies reported the effects of EC injury on the microcirculation in sepsis, including changes in vascular permeability, coagulation dysfunction, vasomotor regulation, and inflammatory responses. These pathways interact and ultimately lead to septic microcirculation disorders.
CONCLUSION: Sepsis-induced endothelial dysfunction involves various interconnected mechanisms, which collectively compromise ECs and impede microcirculatory perfusion. Future research should enhance current understanding of endothelial injury mechanisms, develop synergistic multi-target strategies to disrupt this cycle, and facilitate the clinical application of endothelial markers for early intervention and dynamic assessment.
