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Publications

Journal Article Review Research Support, Non-U.S. Gov't Epublish 36 citations

PubMed: 37581311 DOI: 10.1172/JCI170502

The vascular perspective on acute and chronic lung disease.

J Clin Invest 133(16)

Authors: Izabela Borek, Anna Birnhuber, Norbert F Voelkel, Leigh M Marsh, Grazyna Kwapiszewska

Affiliations

  • Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria.
  • Otto Loewi Research Center, Division of Physiology and Pathophysiology, Medical University of Graz, Graz, Austria.
  • Pulmonary Medicine Department, University of Amsterdam Medical Centers, Amsterdam, Netherlands.
  • Department of Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam University Medical Centers, Amsterdam, Netherlands.
  • Institute for Lung Health, German Lung Center (DZL), Cardiopulmonary Institute, Giessen, Germany.

Abstract

The pulmonary vasculature has been frequently overlooked in acute and chronic lung diseases, such as acute respiratory distress syndrome (ARDS), pulmonary fibrosis (PF), and chronic obstructive pulmonary disease (COPD). The primary emphasis in the management of these parenchymal disorders has largely revolved around the injury and aberrant repair of epithelial cells. However, there is increasing evidence that the vascular endothelium plays an active role in the development of acute and chronic lung diseases. The endothelial cell network in the capillary bed and the arterial and venous vessels provides a metabolically highly active barrier that controls the migration of immune cells, regulates vascular tone and permeability, and participates in the remodeling processes. Phenotypically and functionally altered endothelial cells, and remodeled vessels, can be found in acute and chronic lung diseases, although to different degrees, likely because of disease-specific mechanisms. Since vascular remodeling is associated with pulmonary hypertension, which worsens patient outcomes and survival, it is crucial to understand the underlying vascular alterations. In this Review, we describe the current knowledge regarding the role of the pulmonary vasculature in the development and progression of ARDS, PF, and COPD; we also outline future research directions with the hope of facilitating the development of mechanism-based therapies.

MeSH

Pulmonary Disease, Chronic Obstructive, Lung Diseases, Respiratory Distress Syndrome, Endothelial Cells

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