Abstract
Endothelial cells are unique multifunctional cells with basal and inducible metabolic
and synthetic functions. Various stimuli can induce physiological or pathological
changes in endothelial cell biology. Hematopoietic stem cell transplantation (HSCT)
requires high-dose irradiation and/or chemotherapy and is associated with increased
risk of bacterial infections and immune reactions. These factors can affect endothelial
cells. This review provides an overview of the effects of HSCT on endothelial cells,
based on findings observed in cultured cells as well as in patients. We first describe
to what extent irradiation and chemotherapy constitute direct and indirect triggers
for endothelial cell activation and injury. Then, we highlight the role of the endothelium
in several complications of HSCT, including capillary leak syndrome, engraftment syndrome,
transplant-associated microangiopathy, graft-versus-host disease, and diffuse alveolar
hemorrhages. We also analyze in detail available data on sinusoidal obstruction syndrome,
previously known as veno-occlusive disease of the liver, where liver sinusoidal endothelial
cells are first injured and eventually lead to sinusoid occlusion and liver cell damage.
Finally, we open the question of the possible contribution of endothelial damage to
cardiovascular events occurring long after HSCT.
Keywords
endothelial cells - endothelial damage - sinusoidal obstruction syndrome - hematopoietic
stem cell transplant
