Autophagy: The Principal Regulator of Vascular Function and Homeostasis

Abstract

Background: Vascular endothelium is more than just a selective barrier asit acts like a vast organ that functions continuously to regulate vascular tone, permeability, thromboregulation, leukocyte trafficking and angiogenesis. So, it is unsurprising that an early common abnormalityin conditions such asatherosclerosis, hypertension and diabetic vasculopathy is the loss of endothelial homeostasis. The lysosome-dependent recycling and quality-control mechanism known as autophagy has emerged as a crucial component in preserving endothelial stability.This review describes how autophagy is regulated in endothelial cells, summarizes its key physiological roles, and clarifies its context-dependent, reciprocal impacts on both health and disease. Our goal is torelatemolecular mechanisms with vascular functionand potential treatment options.

Methodology: We used the following MeSH terms and keywords to search PubMed, Scopus, and Web of Science for Englishpublications up until October 2023: "Autophagy," "Endothelial cells," "Endothelium," "Mitophagy," "Vascular homeostasis," "Endothelial dysfunction," "Atherosclerosis," "Hypertension," "Diabetes," "Ischemia–reperfusion," "Nitric oxide," "Shear stress," "mTOR" and "AMPK." Then, we manually went through the citation lists of significant primary research and reviews. To ensure that the information was current and accurate, emphasis was placed on recent high-impact studies, systematic reviews and meta-analyses.

Conclusion: Basal autophagy promotes redox balance, endothelial barrier integrity, Nitric Oxide (NO) signaling, mitochondrial quality control, and blood flow adaptation. Major vascular pathologies are significantly impacted by dysregulated (Excessive or insufficient) autophagic flux. As the effects of autophagy vary greatly depending on the circumstance and stage, the therapeutic modulation must be highly precise, with an emphasis on the endothelium, appropriate timing and solid clinical monitoring. Although selective pharmacologic approaches and lifestyle strategies (Exercise, diet restriction etc.) show promise, specificity and suitable flux biomarkers remain crucialunmet needs.

JBRMC, Volume 08   Issue 02  July 2026 ; 45-51