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Connexin43 (Cx43), encoded by the GJA1 gene, plays a crucial role in the formation of hemichannels and the assembly of gap junctions between adjacent cells, facilitating the efficient transport of ions and small molecules. Increasingly studies have revealed the regulatory roles of Cx43 in endothelial cells. Cx43 is not only implicated in the normal function of endothelial cells such as regulating the endothelial barrier, promoting endothelial angiogenesis, regulating vascular tone, and other subtle regulations, but also contributed to endothelial dysfunction, including inflammatory responses, endothelial cell death, and increased endothelial permeability. Here we provide a summary of the current understanding of Cx43 in the pathogenesis of atherosclerosis, hypertension, stroke, and diabetes. In addition, the potential therapeutic approaches targeting Cx43 are also proposed.
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