role of inhaled steroids in vascular airway remodelling in asthma and copd吸入类固醇的作用在血管在哮喘气道重构的发生和慢性阻塞性肺病.pdfVIP

Hindawi Publishing Corporation International Journal of Endocrinology Volume 2012, Article ID 397693, 6 pages doi:10.1155/2012/397693 Review Article Role of Inhaled Steroids in Vascular Airway Remodelling in Asthma and COPD Alfredo Chetta and Dario Olivieri Department of Clinical and Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Padiglione Rasori, Azienda Ospedaliero-Universitaria, Viale Rasori 10, 43125 Parma, Italy Correspondence should be addressed to Alfredo Chetta, chetta@unipr.it Received 11 July 2012; Revised 5 September 2012; Accepted 10 September 2012 Academic Editor: Andrew Chan Copyright © 2012 A. Chetta and D. Olivieri. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In chronic obstructive airway diseases, such as asthma and chronic obstructive pulmonary disease (COPD), changes in bronchial microvasculature are present in response to inflammatory stimuli. Vascular changes may significantly contribute to airway wall remodelling. Angiogenesis and vascular leakage are prevalent in asthma, while vasodilation and vascular leakage dominate in COPD. An endothelial dysfunction may be present both in asthma and in COPD. Vascular changes may occur simultaneously with the thickening of the airway wall and the narrowing of the bronchial lumen. Consequently, pharmacological control of bronchial vascular remodelling may be crucial for symptom control in asthma and COPD. In asthmatic airways, inhaled steroids can downregulate vascular remodelling by acting on proangiogenic factors. Additionally, studies on combination therapy with long-acting β2-agonists and