Bronchial Vascular Remodeling in Asthma and COPD PDF

Preface

Asthma, a common chronic disease affecting millions of people worldwide, causes substantial social and economic impact. Although current therapies effectively target airway inflammation and bronchoconstriction, there is less evidence to suggest that these treatments alter the progression of chronic structural changes within the airways of patients with severe asthma, including subepithelial deposition of collagen, increases in airway smooth muscle cell mass, mucus gland hyperplasia, and mucosal neovascularization. Collectively, these histologic findings define airway remodeling, the subject of another edition in this series.

Considerable research effort and clinical interest focuses on mechanisms of airway inflammation and hyperresponsiveness in both asthma and chronic obstructive pulmonary disease; however, our knowledge of bronchial vascular remodeling remains limited. In addition, the process of bronchial vascular remodeling may be vastly different that that seen in the pulmonary or coronary vessels, due to tissue-specific responses to hypoxia and inflammation.

Mucosal neovascularization, along with bronchial vascular dilatation and leakage, may contribute to airway wall remodeling by altering wall thickness and compliance. Less well understood is the potential for angiogenic factors derived from lung stromal cells to contribute to other aspects of airway remodeling, such as expression of adhesion molecules, deposition of extracellular matrix, or promotion of airway hyperresponsiveness. Angiogenic factors may also be important for survival of alveolar cells.

This book brings together investigators with expertise in basic science, physiology, pathology, pharmacology, and medicine in an attempt to elucidate the mechanisms that regulate the development of bronchial vascular remodeling in asthma and chronic obstructive pulmonary disease. The efficacy of current pharmacotherapy, as well as the potential impact of novel approaches, are also discussed.