Pisi Giovanna, Olivieri Dario, Chetta Alfredo
Department of Paediatrics, Cystic Fibrosis Unit, University of Parma, Parma, Italy.
Inflamm Allergy Drug Targets. 2009 Jul;8(3):176-81. doi: 10.2174/187152809788681047.
Bronchial airway microvasculature consists in a developed network of vessels, which plays an important role in normal homeostasis as well as in inflammatory airway processes. Its airway autonomic neural control includes cholinergic and adrenergic innervation, as well as nonadrenergic noncholinergic system. The nerve/vessel interplay is complex and not yet completely clarified. In response to inspired air conditions, the sensory nerves can recruit appropriate reflexes, which can induce different vascular processes, such as vasodilatation, vasoconstriction, plasma extravasation and exudation. Additionally, the stimulation of C fibres may result in an axon local reflex with antidromic conduction down afferent nerve collaterals and release of sensory neuropeptides, which in turn may act on the mucosal vasculature to promote vasodilatation and microvascular leakage. The neurogenic inflammation may play a key role in allergic diseases, such as asthma, as well as in COPD, a smoking-related disease. This review deals with the interactions of vessels and nerves within the airway mucosa under healthy conditions and in inflammatory diseases. The clinical and pharmacological implications are also described.
支气管气道微血管系统由一个发达的血管网络组成，它在正常稳态以及气道炎症过程中发挥着重要作用。其气道自主神经控制包括胆碱能和肾上腺素能神经支配，以及非肾上腺素能非胆碱能系统。神经与血管之间的相互作用很复杂，尚未完全阐明。响应吸入空气的状况，感觉神经可引发适当的反射，这些反射可诱导不同的血管过程，如血管舒张、血管收缩、血浆外渗和渗出。此外，C纤维的刺激可能导致轴突局部反射，其沿传入神经侧支进行逆向传导并释放感觉神经肽，这反过来可能作用于黏膜血管系统以促进血管舒张和微血管渗漏。神经源性炎症可能在过敏性疾病如哮喘以及慢性阻塞性肺疾病（一种与吸烟相关的疾病）中起关键作用。本综述探讨了健康状况下以及炎症性疾病中气道黏膜内血管与神经的相互作用。还描述了其临床和药理学意义。
