Endothelial barrier and sepsis: mechanisms and potential therapeutic strategies

Sepsis is a life-threatening condition characterized by an exaggerated and uncontrolled immune response, leading to widespread inflammation throughout the body. This immune response can compromise the integrity of the endothelial barrier, resulting in increased vascular permeability. The degree of vascular permeability in septic shock patients correlates with disease severity and significantly influences the outcomes of resuscitation and prognosis. This review systematically examines the structural regulation of the endothelial barrier and the dynamic mechanisms of its injury in subgroups of sepsis. In response to these mechanisms, emerging therapeutic strategies focus on glycocalyx protection, signal pathway modulation, cytoskeleton stability, and immune regulation, aiming to restore endothelial barrier function through multi-target synergism. In the future, combining analysis of endothelial barrier function and the dynamic regulation mechanism provides a new perspective for the precise treatment of sepsis.