Summary

The initial steps in the pathogenesis of atherosclerosis involvechanges to the vascular endothelium, which produces numer-oussubstances involved in the regulation and maintenance ofvascular integrity and the homeostasis of the coagulation/fibri-nolysissystem. A further change in endothelial physiology is anincrease in the surface expression of cell adhesion molecules,such as E-selectin, which regulate adhesive interactionsbetween certain blood cells and endothelium. As E-selectin isonly expressed on activated endothelium, it therefore provides an opportunity to study pathophysiological aspects of this cellin cardiovascular and other disease. However, a soluble form ofE selectin (i.e. sE-selectin) can be found in the plasma. Thisreview will focus on sE-selectin, and its potential role in thepathogenesis of cardiovascular disease as raised levels havebeen found in hypertension, diabetes and hyperlipidemia,although its association in established atherosclerosis diseaseand its value as a prognostic factor is more controversial.