Department of Radiation Oncology, University Medical Center Groningen, University of Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands.
Thorax. 2012 Apr;67(4):334-41. doi: 10.1136/thoraxjnl-2011-200346. Epub 2011 Dec 26.
Pulmonary arterial hypertension (PAH) is a commonly fatal pulmonary vascular disease that is often diagnosed late and is characterised by a progressive rise in pulmonary vascular resistance resulting from typical vascular remodelling. Recent data suggest that vascular damage plays an important role in the development of radiation-induced pulmonary toxicity. Therefore, the authors investigated whether irradiation of the lung also induces pulmonary hypertension.
Different sub-volumes of the rat lung were irradiated with protons known to induce different levels of pulmonary vascular damage.
Early loss of endothelial cells and vascular oedema were observed in the irradiation field and in shielded parts of the lung, even before the onset of clinical symptoms. 8 weeks after irradiation, irradiated volume-dependent vascular remodelling was observed, correlating perfectly with pulmonary artery pressure, right ventricle hypertrophy and pulmonary dysfunction.
The findings indicate that partial lung irradiation induces pulmonary vascular remodelling resulting from acute pulmonary endothelial cell loss and consequential pulmonary hypertension. Moreover, the close resemblance of the observed vascular remodelling with vascular lesions in PAH makes partial lung irradiation a promising new model for studying PAH.
肺动脉高压（PAH）是一种常见的致命性肺血管疾病，通常诊断较晚，其特征是肺血管阻力逐渐升高，这是由于典型的血管重塑所致。最近的数据表明，血管损伤在放射性肺毒性的发展中起重要作用。因此，作者研究了肺部照射是否也会引起肺动脉高压。
用已知会引起不同程度肺血管损伤的质子照射大鼠肺部的不同亚体积。
在照射野和肺部屏蔽部位，甚至在临床症状出现之前，就观察到内皮细胞早期丢失和血管水肿。照射 8 周后，观察到与照射体积相关的血管重塑，与肺动脉压、右心室肥厚和肺功能障碍完全相关。
这些发现表明，部分肺照射会导致急性肺内皮细胞丢失和随后的肺动脉高压引起的肺血管重塑。此外，观察到的血管重塑与 PAH 中的血管病变非常相似，这使得部分肺照射成为研究 PAH 的一种很有前途的新模型。
