Have you ever heard the word 'Endothelin'? You may have heard a doctor mention this name to you or someone in your family when talking about medicine, or you may have seen it somewhere when reading about a disease. Although this is actually a small thing that is produced inside our bodies, it does a great job of keeping our blood pressure, or 'pressure' as we all know it, at the right level. However, if this endothelin increases in the body more than necessary, various health problems can occur. So, today we will talk about what this endothelin is and what it does to our body in a simple way that you can understand.
So what is this endothelin?
Simply put, endothelin is a small protein that helps constrict blood vessels in our bodies. To be precise, it is a peptide. Peptides are short protein chains made up of small things called amino acids. These also help build larger proteins in our bodies.
Do you know who makes this endothelin? There is a layer of cells inside our blood vessels. It is called the endothelium. This is the main place in our body that produces endothelin.
What is endothelium? Can you explain it a little?
Think of the blood vessels throughout our bodies as a network of pipes that carry water. The inside of those pipes, on the side where the blood flows, is covered by a very thin layer of cells. That layer of cells is called the endothelium . As surprising as it may seem, it is also considered one of the largest organs in our body!
These endothelial cells secrete various substances. These substances control the dilation and constriction of our blood vessels, which is called vascular tone . This vascular tone determines how hard our heart has to pump blood and how hard it has to work to circulate blood throughout the body.
The endothelium and endothelin work together to perform several other important functions:
- It helps blood clot. This is very important to stop bleeding when you get a wound.
- It controls the levels of fluids and salts (electrolytes) in our blood.
- It also helps control inflammation by preventing toxins from entering our tissues.
So what does endothelin do to the body?
We've already mentioned that endothelin is something that helps constrict blood vessels. In fact, endothelin is the most powerful vasoconstrictor in our body. Let's break this word down a bit:
- The "Vaso" part refers to the blood vessels in our cardiovascular system.
- "Constrictor" or " constriction" means the narrowing or constriction of blood vessels. This slows down the flow of blood, and sometimes even stops it.
So, what endothelin does is increase our blood pressure. When blood vessels become constricted, the heart has to work harder to pump blood. That's why the pressure increases.
What happens if endothelin levels increase?
Normally, endothelin works in a beneficial way for our body. However, if for some reason this endothelin level increases in the body, it can cause a number of diseases that damage our heart and lungs . Imagine what happens if a water pipe becomes too clogged. It's like that.
Some of the conditions that can be caused by increased endothelin levels are:
- Atherosclerosis (arterial disease): In this, fat deposits build up inside the blood vessels , narrowing the vessels.
- Broken heart syndrome : A weakening of the heart due to sudden stress.
- There are several types of cancer .
- Cardiomyopathy : Weakening of the heart muscle.
- Cardiovascular (heart) disease and heart failure.
- Coronary artery disease , as well as a condition called endothelial dysfunction .
- High blood pressure and preeclampsia .
- Kidney disease and kidney failure .
- Pulmonary fibrosis and pulmonary hypertension .
- Scleroderma : Thickening of the skin and connective tissue.
Imagine, Nimal has had high blood pressure for a while. The doctor said that his blood vessels are a bit narrowed, and that his endothelin levels may be affecting it. He also warned that if he doesn't take his medication properly, it could lead to a heart attack. So, it's not a good idea to take this endothelin thing lightly.
Are there types of endothelin?
Yes, there are types of endothelins. Medical researchers first identified them in 1987. There are three main types of endothelins, which are made up of four amino acid peptides. All three are vasoconstrictors.
The most common and most potent type of endothelin in our bodies is endothelin-1 (ET-1). Researchers are still learning how the other two types, endothelin-2 (ET-2) and endothelin-3 (ET-3), affect our bodies. Currently, most of the attention is focused on ET-1.
What are endothelin receptors?
Every tissue in our body has endothelin receptors. These receptors are like doorknobs. When endothelin molecules come and bind to these receptors, they send a message to those cells to do something. This is how endothelin communicates with cells throughout our bodies.
How are endothelin levels measured?
If doctors want to know what your endothelin levels are, they will do a blood test . This measures the level of endothelin-1 (ET-1). It is found in a part of the blood called plasma. Plasma is the liquid part of the blood that is left after the red blood cells, white blood cells, and platelets have been removed.
This blood test can be done at your doctor's office, a hospital, or a lab. Other types of endothelin are difficult to measure in blood this way.
The unit of measurement for endothelin is picograms per milliliter (pg/mL).
- The normal ET-1 plasma level in an adult is about 1 pg/mL to 2 pg/mL.
- The ET-1 levels in young children are slightly higher.
- Also, there may be slight differences in these levels between different nations.
Typically, people with certain heart or lung conditions, such as pulmonary arterial hypertension, have elevated ET-1 levels. Also, some heart treatments, such as balloon angioplasty, can temporarily increase endothelin levels.
What are Endothelin Receptor Antagonists (ERA)?
These are a type of medication that is given when the level of endothelin increases. Endothelin Receptor Antagonists (ERA) work by reducing the amount of endothelin in our body.
These belong to a type of treatment called ``targeted therapy.`` That is, these drugs go exactly and attack only the problematic cells, without causing much damage to healthy cells. Like a sniper, they hit exactly the target. ERA drugs are mainly used to treat certain types of high blood pressure in the lungs (pulmonary arterial hypertension).
Are there any side effects to these ERA medications?
Like any medication, ERA medications can cause some side effects.
- Pregnant women or women who are trying to get pregnant should not take these ERA medications. This is because these medications can cause birth defects in the unborn child. This is a very important issue.
- Very rarely, this medication can cause liver damage. Therefore, your doctor may order blood tests to check your liver health regularly.
- Other possible side effects are:
- Constipation.
- Facial swelling (edema) or flushing.
- Headache .
- Nausea and vomiting.
- Rapid pulse and heart rate.
If you feel something like this, you should tell your doctor immediately so he can take the necessary steps.
So, what are the things we should remember from this story? (Take-Home Message)
Okay, we've talked a lot about endothelin. In short:
- Endothelin is an important protein produced in the body that helps constrict our blood vessels and control blood pressure.
- This is made from a layer of cells called the endothelium that lines the inside of our blood vessels.
- If endothelin levels become too high, blood vessels can become too constricted, leading to problems like high blood pressure, heart disease, and lung disease .
- Endothelin-1 (ET-1) levels in the blood can be measured with a blood test .
- Endothelin receptor antagonists (ERAs) are a type of medication that lowers endothelin levels. They are used specifically for high blood pressure in the lungs.
- If you are taking ERA medication, you should be especially careful during pregnancy and with your liver health.
So, if you or someone you know has a problem with Endothelin, it is best to seek medical advice. I hope this article has given you some insight. Stay healthy!
` Endothelin, blood pressure, heart disease, lung disease, endothelium, peptides
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