The role of the bronchial microvasculature in the airway remodelling in asthma and COPD.

The role of the bronchial microvasculature in the airway remodelling in asthma and COPD.
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DOI:
10.1186/1465-9921-11-132
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发表时间:
2010-09-29
影响因子:
5.8
通讯作者:
Olivieri D
Olivieri D
中科院分区:
医学2区
文献类型:
--
作者:
Zanini A;Chetta A;Imperatori AS;Spanevello A;Olivieri D

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近年来,人们越来越关注慢性支气管炎症(如哮喘和COPD)气道重塑的血管成分及其在疾病进展中的作用。特别是,哮喘患者的支气管粘膜血管化程度更高,显示出血管和血管面积的数量和尺寸更高。近年来,人们对血管内皮生长因子(VEGF)在促进血管重塑和血管生成中的关键作用有了新的认识。对活检、诱导痰或BAL进行的许多研究表明,VEGF及其受体参与血管重塑过程。据推测,气道重塑的血管成分是一个复杂的多步骤现象,涉及几种介质。在常见的哮喘和COPD药物中,只有吸入性皮质类固醇显示出真实的逆转血管重塑的所有方面的能力。本综述的目的是分析气道重塑的血管成分的形态学方面和可能的机制参与哮喘和COPD。我们还关注了支气管微血管变化在哮喘和COPD中的功能和治疗意义。
In recent years, there has been increased interest in the vascular component of airway remodelling in chronic bronchial inflammation, such as asthma and COPD, and in its role in the progression of disease. In particular, the bronchial mucosa in asthmatics is more vascularised, showing a higher number and dimension of vessels and vascular area. Recently, insight has been obtained regarding the pivotal role of vascular endothelial growth factor (VEGF) in promoting vascular remodelling and angiogenesis. Many studies, conducted on biopsies, induced sputum or BAL, have shown the involvement of VEGF and its receptors in the vascular remodelling processes. Presumably, the vascular component of airway remodelling is a complex multi-step phenomenon involving several mediators. Among the common asthma and COPD medications, only inhaled corticosteroids have demonstrated a real ability to reverse all aspects of vascular remodelling. The aim of this review was to analyze the morphological aspects of the vascular component of airway remodelling and the possible mechanisms involved in asthma and COPD. We also focused on the functional and therapeutic implications of the bronchial microvascular changes in asthma and COPD.
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