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Prepublished online as a Blood First Edition Paper on January 23, 2003; DOI 10.1182/blood-2002-06-1887.

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Blood, 15 May 2003, Vol. 101, No. 10, pp. 3765-3777

REVIEW ARTICLE

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

William C. Aird

From the Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA.

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 sepsis 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 endothelial cell function. The goals of this article are to (1) provide an overview of sepsis and its complications, (2) discuss the role of the endothelium in orchestrating the host response in sepsis, and (3) emphasize the potential value of the endothelium as a target for sepsis therapy.


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