Heath D, Madden B, Yacoub M
Department of Pathology, University of Liverpool, London.
Physiol Bohemoslov. 1990;39(4):309-13.
A study of the numbers of pulmonary endocrine cells per cm2 of section of lung obtained at combined heart-lung transplantation in 25 cases of plexogenic pulmonary arteriopathy demonstrated that the peptide which may become unduly prominent in pulmonary arterial disease is bombesin. The type of vascular disease in which bombesin becomes prominent is plexogenic pulmonary arteriopathy, be this primary or secondary to congenital heart disease. The increased prominence of bombesin appears to be related to the stage reached in the arteriopathy. Increased numbers of pulmonary endocrine cells are found in association with classic cellular plexiform lesions with narrow vascular channels. Their numbers are within normal limits when the plexiform lesions are mature with wide vascular channels and narrow intervening septa. The pulmonary endocrine cells are most prominent in the pre-plexiform stage when smooth muscle cells in the inner half of the media of the pulmonary artery show increased electron density, and migrate through gaps in the inner elastic lamina to reach the intima. Here they are transformed into myofibroblasts and proliferate. The migration of muscle cells may be related in some way to long-acting trophic factors released from the pulmonary endocrine cells into the surrounding tissues from which they reach the blood and hence the pulmonary arteries.
一项对25例致丛性肺动脉病患者心肺联合移植时获取的每平方厘米肺切片中肺内分泌细胞数量的研究表明，在肺动脉疾病中可能过度突出的肽是蛙皮素。蛙皮素突出的血管疾病类型是致丛性肺动脉病，无论是原发性的还是继发于先天性心脏病的。蛙皮素突出程度的增加似乎与动脉病所达到的阶段有关。在伴有狭窄血管通道的典型细胞性丛状病变中发现肺内分泌细胞数量增加。当丛状病变成熟，血管通道宽阔且间隔狭窄时，它们的数量在正常范围内。肺内分泌细胞在丛状前阶段最为突出，此时肺动脉中膜内半层的平滑肌细胞显示电子密度增加，并通过内弹性膜的间隙迁移至内膜。在这里它们转化为肌成纤维细胞并增殖。肌肉细胞的迁移可能在某种程度上与肺内分泌细胞释放到周围组织中的长效营养因子有关，这些因子从周围组织进入血液，进而进入肺动脉。
