Blood vessel integrity

Blood vessel integrity refers to the structural and functional stability of the vascular wall, primarily governed by the endothelial cell barrier that regulates the exchange of fluid, solutes, and cells between the bloodstream and surrounding tissues [3, 5]. This integrity is actively maintained through complex molecular signaling involving adherens junctions (anchored by VE-cadherin), tight junctions, and the supportive role of mural cells like pericytes and the extracellular matrix [5, 12]. It is not a single molecular target but rather a physiological state; however, it is a critical therapeutic objective in various systemic and organ-specific diseases [1, 11]. Loss of vascular integrity, or 'vascular leak,' is a central feature of pathologies such as sepsis, acute respiratory distress syndrome (ARDS), and diabetic macular edema [1, 9, 10]. In these conditions, inflammatory cytokines or growth factors like VEGF trigger the disassembly of junctional complexes, leading to life-threatening edema and organ dysfunction [5, 12]. Drugs aimed at restoring blood vessel integrity typically target specific molecules in the Angiopoietin/Tie2 axis, the Wnt/Frizzled pathway, or inhibit permeability-inducing factors like VEGF to stabilize the endothelial barrier and improve clinical outcomes [5, 7, 10].

Other names

Vascular integrityEndothelial barrier functionVascular stabilityEndothelial integrityMicrovascular integrity

Stabilization of endothelial cell-cell junctions (e.g., VE-cadherin), activation of Tie2 receptor signaling pathways, inhibition of pro-permeability factors such as VEGF-A and Angiopoietin-2, and reinforcement of the basement membrane through pericyte recruitment [5, 9, 10].