Significance of pulmonary endothelial injury and the role of cyclooxygenase-2 and prostanoid signaling

The endothelium plays a key role in the dynamic balance of hemodynamic, humoral and inflam-matory processes in the human body. Its central importance and the resulting therapeutic concepts are the subject of ongoing research efforts and form the basis for the treatment of numerous dis-eases. The pulmonary endothelium is an essential component for the gas exchange in humans. Pulmonary endothelial dysfunction has serious consequences for the oxygenation with the poten-tial of consecutive multiple organ failure. Therefore, we provide an overview of pulmonary endo-thelial dysfunction due to viral, bacterial and fungal infections, ventilator induced injury or aspi-ration in a medical context. The elucidation of the underlying causes and mechanisms of damage and repair results in new therapeutic approaches. Specific emphasis is placed on the processes leading to the induction of cyclooxygenase-2 and downstream prostanoid-based signaling path-ways associated with this enzyme.