The role of the endothelium in severe sepsis and multiple organ dysfunction syndrome

Severe sepsis, defined as sepsis with acute organ dysfunction, is associated with high morbidity and mortality rates. The development of novel therapies for sepsis is critically dependent on an understanding of the basic mechanisms of the disease. The pathophysiology of severe sepals involves a highly complex, integrated response that includes the activation of a number of cell types, inflammatory mediators, and the hemostatic system. Central to this process is an alteration of endothellal cell function. The goals of this article are to (1) provide an overview of sepals and its complications, (2) discuss the role of the endothellum in orchestrating the host response in sepsis, and (3) emphasize the potential value of the endothellum as a target for sepsis therapy. (C) 2003 by The American Society of Hematology.