The endothelium is the layer of cells lining the blood vessels in animals. It weighs more than one kilogram in adult humans, and it covers a surface area of 4000 to 7000 square meters. The endothelium is the cellular interface between the circulating blood and underlying tissue. As the medium between these two sets of tissues, endothelium is part of many normal and disease processes throughout the body. The endothelium responds to signals from its surrounding environment to help regulate functions like the resistance that blood vessels need to pump blood through the body (vasomotor tone), the policing of substances trying to enter or exit the blood vessel (blood vessel permeability), and the ability of blood to clot (hemostasis). In addition to diseases like atherosclerosis, endothelium has been indicated as a component in pathologies like cancer, asthma, diabetes, hepatitis, multiple sclerosis, and sepsis. The shape, size, and appearance of endothelial cells, called their phenotypes, vary depending upon which part of the body the cells are from, a property called phenotypic heterogeneity. The endothelium, its properties, and its responses to stimuli are governed largely by the local environment of the cells.

Elizabeth Dexter Hay studied the cellular processes that affect development of embryos in the US during the mid-twentieth and early twenty-first centuries. In 1974, Hay showed that the extracellular matrix, a collection of structural molecules that surround cells, influences cell behavior. Cell growth, cell migration, and gene expression are influenced by the interaction between cells and their extracellular matrix. Hay also discovered a phenomenon later called epithelial-mesenchymal transition, a process that occurs during normal embryo and adult development in which epithelial cells, cells that line external and internal surfaces of the body, transform into mesenchymal stem cells, connective tissue cells that are capable of turning into other cell types. Hay's work helped researchers explain normal developmental processes and enabled research into abnormal processes that can cause developmental defects and diseases.