Immunological Aspects of the Vascular Endothelium

Author: Caroline O. S. Savage
Published: January 1994
Publisher: Cambridge University Press
ISBN: 052145249X
Hardcover Book
Number of Pages: 261

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This is the first volume to look in depth at the functioning of the vascular endothelium, and the diseases and tissue injury that arise as a result of inflammation and immunological responses. The vascular endothelium is a metabolically highly active layer of cells lining all blood vessel walls. Through its interactions with leukocytes and other mediators, it is central to the development of inflammatory foci and to lymphocyte trafficking around the body. Tissue injury may arise here as a result of abnormal inflammatory or immune responses. The potential such injury to contribute to autoimmune disease is discussed in this book, particularly in relation to autoimmune vascular disease of the renal, rheumatological and neurological systems, as well as in organ transplantation. This is a stimulating monograph on the unfolding revelations of the immunologic functions of endothelium. The book emphasizes the functional aspects of the endothelial cell and endothelium as an immune organ. It is aimed at basic and clinical immunologists and advanced subspecialists. Most chapters are extremely well written, complete, and as current as can be with print-time limitations. The first half of the book, which provides a unifying source on the recent explosion of new knowledge concerning the immune functions of endothelium, is better than the second half. It may, however, have been a bit premature to specifically implicate endothelial dysfunction as an etiologic component of several of the common autoimmune diseases. Most of these chapters lack substance or convincing data. However, this fault, usually major, is attenuated because several stimulating hypotheses that may begin to dispel current obsolescent and rigid dogma concerning autoimmune diseases etiologies are included. Refocusing potential avenues of investigation in these diseases, currently still quite mysterious in spite of decades of research, could be very helpful. Several authors display the healthy skepticism so characteristic of British immunologists in general concerning the rather facile but time-honored concept that native DNA/anti-DNA complexes are the primary disease mediators in SLE. Consideration of new and different etiologies of SLE is an exciting development and may serve to change perspective on this puzzling disease. This book is recommended for readers interested in the endothelium and its rapid ascendance to the status of an immunologic organ. Savage, Caroline O.S. (Univ of Birmingham); Pearson, Jeremy D. (King's Coll School of Medicine and Dentistry, London)The contributors represent the specialties of rheumatology, ophthalmology, nephrology, pharmacology, and vascular biology. Most are from research institutions, hospitals, and universities in the U.K., with two from Italy. Institutions prominently represented include King's Coll, Univ of Birmingham, and Hammersmith Hospital.

Table of Contents
List of contributors
Preface
1 New concepts of mechanisms in autoimmunity 1
2 Regulation of endothelial cell function by cytokines 20
3 Interactions between granulocytes and endothelium 43
4 The regulation of lymphocyte migration by vascular endothelium and its role in the immune response 64
5 Role of the vascular endothelium in immunologically mediated neurological diseases 96
6 The role of the endothelium in systemic lupus erythematosus and Sjogren's syndrome 124
7 The role of the endothelium in rheumatoid arthritis and scleroderma 153
8 The role of the endothelium in systemic vasculitis 173
9 Endothelial involvement in childhood Kawasaki disease 200
10 The role of the endothelium in thrombotic thrombocytopaenic purpura and haemolytic uraemic syndrome 213
11 The immunological role of the endothelium in organ transplantation 233
Index 253

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