Endothelium and endothelin: regulators of arterial stiffness and fibrinolysis in ANCA-associated vasculitis

In this issue, Farrah et al. report clinical investigations in patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV). They demonstrate that endothelium-dependent vasodilatation, fibrinolytic capacity, and monocyte-dependent endothelin-1 clearance are reduced in patients with AAV, whereas circulating levels of endothelin-1 and vascular stiffness are increased. Acute infusion of an endothelin ETA receptor antagonist reduced vasoconstriction and arterial stiffness. This Commentary discusses biological insights and clinical implications of this study.