Vascular remodelling in asthma.
OBJECTIVE
We review the recent literature, focusing on 2006 and 2007, to produce an update on the patho-biology of angiogenesis and vascular endothelial growth factor in the asthmatic airway.


RESULTS
In terms of conceptual development in asthma research, airway inflammation and remodelling have been regarded as separate processes or perhaps as sequential, with early inflammation leading later to remodelling. Recent insights identify a central role for vascular endothelial growth factor in stimulating both inflammation and vascular remodelling coincidentally, with the full panoply of vascular endothelial growth factor mediated events being complex and wide. Both nitric oxide and matrix metalloproteinase-9 induction may be important downstream pathogenic mechanisms. Virus-mediated exacerbations are a prime manifestation of the oscillating trajectory of clinical asthma. The early stimulation of vascular endothelial growth factor production is probably a central aetiological mechanism, with secondary inflammation and angiogenesis. The time scale of the latter, especially, fits with the time scale of clinico-physiological changes after exacerbation. These vascular endothelial growth factor induced changes are potentially modifiable with therapy.


CONCLUSIONS
Insights into the importance of vascular endothelial growth factor and angiogenesis in asthma pathogenesis now lead to potential new therapeutic possibilities and elucidate why recent advances in asthma therapeutics have been so successful.
Walters
Eugene Haydn
EH
Respiratory Research Group, Menzies Research Institute, University of Tasmania, Australia. haydn.walters@utas.edu.au
Soltani
Amir
A
Reid
David William
DW
Ward
Chris
C
D000293:Adolescent; D000420:Albuterol / Q000031:analogs & derivatives / Q000627:therapeutic use; D000818:Animals; D001249:Asthma / Q000188:drug therapy / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D006801:Humans; D020780:Matrix Metalloproteinase 9 / Q000276:immunology / Q000378:metabolism; D051379:Mice; D008822:Mice, Transgenic; D009389:Neovascularization, Pathologic; D019001:Nitric Oxide Synthase / Q000276:immunology / Q000378:metabolism; D012137:Respiratory System / Q000098:blood supply* / Q000276:immunology / Q000503:physiopathology; D000068299:Salmeterol Xinafoate; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000276:immunology* / Q000378:metabolism*
D001993:Bronchodilator Agents; D042461:Vascular Endothelial Growth Factor A; D000068299:Salmeterol Xinafoate; D019001:Nitric Oxide Synthase; D020780:Matrix Metalloproteinase 9; D000420:Albuterol