Pathophysiological roles of microvascular alterations in pulmonary inflammatory diseases: possible implications of tumor necrosis factor-alpha and CXC chemokines.
Chronic obstructive pulmonary disease (COPD) and bronchial asthma are common respiratory diseases that are caused by chronic inflammation of the airways. Although these diseases are mediated by substantially distinct immunological reactions, especially in mild cases, they both show increased numbers of neutrophils, increased production of tumor necrosis factor-alpha (TNF-alpha) and poor responses to corticosteroids, particularly in patients with severe diseases. These immunological alterations may contribute strongly to airway structural changes, commonly referred to as airway remodeling. Microvascular alterations, a component of airway remodeling and caused by chronic inflammation, are observed and appear to be clinically involved in both diseases. It has been well established that vascular endothelial growth factor (VEGF) plays important roles in the airway microvascular alterations in mild and moderate cases of both diseases, but any role that VEGF might play in severe cases of these diseases remains unclear. Here, we review recent research findings, including our own data, and discuss the possibility that TNF-alpha and its associated CXC chemokines play roles in microvascular alterations that are even more crucial than those of VEGF in patients with severe COPD or asthma.
Orihara
Kanami
K
Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.
Matsuda
Akio
A
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000818:Animals; D001249:Asthma / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D019743:Chemokines, CXC / Q000378:metabolism*; D006801:Humans; D008168:Lung / Q000098:blood supply*; D008833:Microcirculation; D055806:Microvessels / Q000276:immunology* / Q000503:physiopathology; D011652:Pulmonary Circulation; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy / Q000276:immunology* / Q000503:physiopathology; D012720:Severity of Illness Index; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D000305:Adrenal Cortex Hormones; D019743:Chemokines, CXC; D014409:Tumor Necrosis Factor-alpha; D042461:Vascular Endothelial Growth Factor A