Towards a comprehensive endothelial biomarkers profiling and endothelium-guided pharmacotherapy

Endothelial dysfunction has prognostic,diagnostic and therapeutic significance in cardiovascular disease,but the endothelial phenotype is still not measured routinely to stratify the cardiovascular risk and tailor therapy. flow-mediated dilation (fmd),the gold-standard technique for the functional assessment of endothelial function that is increasingly used in clinical settings measures the nitric oxide (no)-dependent function only. however,the endothelial dysfunction involves a plethora of pathophysiologically important biochemical changes beyond alterations in the no bioavailability. still,in many diseases,some plasma protein biomarkers reflecting the pro-thrombotic and the pro-inflammatory endothelial phenotypes have poor selectivity,specificity,and a weak predictive value if they are used alone. therefore,a multi biomarker strategy seems to be a reasonable and promising alternative. here,we propose a multi-biomarker strategy to diagnose the endothelial dysfunction and to monitor the efficacy of an endothelium-targeted therapy. this strategy is based on the panel of endothelial biomarkers,reflecting various aspects and mechanisms of dysfunctional endothelium. the potential of an advanced analytical platform like the ultra-high performance liquid chromatography (uhplc) coupled to mass spectrometry-based multiple reaction monitoring for simultaneous quantification of multiple endothelial biomakers is also discussed. © 2015 institute of pharmacology,polish academy of sciences. published by elsevier sp. z o.o. all rights reserved.