Department of Medicine, Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois; and.
Department of Medicine, Boston University School of Medicine, Boston, Massachusetts.
Am J Respir Cell Mol Biol. 2023 Aug;69(2):135-146. doi: 10.1165/rcmb.2022-0431TR.
Lungs are constantly exposed to environmental perturbations and therefore have remarkable capacity to regenerate in response to injury. Sustained lung injuries, aging, and increased genomic instability, however, make lungs particularly susceptible to disrepair and fibrosis. Pulmonary fibrosis constitutes a major cause of morbidity and is often relentlessly progressive, leading to death from respiratory failure. The pulmonary vasculature, which is critical for gas exchanges and plays a key role during lung development, repair, and regeneration, becomes aberrantly remodeled in patients with progressive pulmonary fibrosis. Although capillary rarefaction and increased vascular permeability are recognized as distinctive features of fibrotic lungs, the role of vasculature dysfunction in the pathogenesis of pulmonary fibrosis has only recently emerged as an important contributor to the progression of this disease. This review summarizes current findings related to lung vascular repair and regeneration and provides recent insights into the vascular abnormalities associated with the development of persistent lung fibrosis.
肺脏不断受到环境变化的影响,因此具有很强的再生能力以应对损伤。然而,持续的肺部损伤、衰老和基因组不稳定性使肺部特别容易出现修复缺陷和纤维化。肺纤维化是发病率的主要原因,且往往呈进行性发展,导致呼吸衰竭而死亡。肺部血管对于气体交换至关重要,并在肺发育、修复和再生过程中发挥关键作用,在进行性肺纤维化患者中会发生异常重塑。尽管毛细血管稀疏和血管通透性增加被认为是纤维化肺部的显著特征,但血管功能障碍在肺纤维化发病机制中的作用最近才被认为是导致该疾病进展的一个重要因素。本综述总结了与肺血管修复和再生相关的最新发现,并提供了与持续性肺纤维化发展相关的血管异常的最新见解。