New insights into endothelial cell physiology and pathophysiology

Endothelial cells, the gatekeepers of vascular permeability, play a pivotal role in vascular homeostasis by controlling inflammatory responses and hemostatic balance. However, their role is not limited to the circulatory system, since they also mediate organ function through numerous signaling pathways and cellular interactions. Recent studies have shown that endothelial cells not only constitute a heterogeneous population but also exhibit adaptive capacity, particularly in response to mechanical or biochemical stimuli. A growing body of research on endothelial cells also highlights their involvement in various pathological conditions, including cardiovascular diseases, inflammatory disorders, and cancer. Furthermore, endothelial progenitor cells represent a valuable therapeutic option in regenerative medicine, and ongoing clinical trials are investigating their use in the treatment of ischemic diseases, myocardial infarction, and organ fibrosis. This manuscript reviews the physiology and pathophysiology of endothelial cells, focusing on recent findings and clinical applications relevant to new therapeutic approaches.