Wang Juan, Zhang Yankun, Liu Huimin, Liu Lingling, Xu Chong, Zhang Jing
Department of Respiratory and Critical Care, Tianjin Medical University General Hospital, Tianjin, 300052, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2025 Aug 15;20:2869-2883. doi: 10.2147/COPD.S521659. eCollection 2025.
Chronic obstructive pulmonary disease (COPD) is a chronic progressive disease of the airways and lungs characterized by persistent respiratory symptoms and airflow limitation. Under hypoxic conditions, endothelial cells and immune cells secrete inflammatory mediators and growth factors, promoting the proliferation of pulmonary vascular smooth muscle cells and fibroblasts, leading to vascular remodeling. Considering the high morbidity and mortality of pulmonary hypertension (PH) in patients with COPD, we investigated the molecular mechanisms underlying vascular remodeling in COPD-related PH. Neurohumoral factor N-terminal brain natriuretic peptide (NT-proBNP), inflammatory mediators, growth factors, and forkhead box M1 (FOXM1) were evaluated as auxiliary diagnostic markers for COPD with PH and chronic cor pulmonale (CCP), aiming to facilitate early PH screening, prevention, and improvement of patient survival and quality of life. Circulating biomarkers (NT-proBNP, inflammatory mediators, growth factors) can be detected via clinical blood sampling, offering non-invasive, convenient diagnostic approaches with high specificity and sensitivity-ideal tools for disease screening. Intracellular molecular marker FOXM1, requiring tissue or enriched cell detection, serves as a histopathological marker and potential target for liquid biopsy, positioning it as a promising future screening tool.
慢性阻塞性肺疾病（COPD）是一种气道和肺部的慢性进行性疾病，其特征为持续的呼吸道症状和气流受限。在低氧条件下，内皮细胞和免疫细胞分泌炎症介质和生长因子，促进肺血管平滑肌细胞和成纤维细胞的增殖，导致血管重塑。鉴于COPD患者中肺动脉高压（PH）的高发病率和高死亡率，我们研究了COPD相关PH中血管重塑的分子机制。评估了神经体液因子N末端脑钠肽（NT-proBNP）、炎症介质、生长因子和叉头框M1（FOXM1）作为COPD合并PH和慢性肺源性心脏病（CCP）的辅助诊断标志物，旨在促进早期PH筛查、预防并改善患者生存率和生活质量。循环生物标志物（NT-proBNP、炎症介质、生长因子）可通过临床采血检测，提供具有高特异性和敏感性的非侵入性、便捷诊断方法——疾病筛查的理想工具。细胞内分子标志物FOXM1需要进行组织或富集细胞检测，作为组织病理学标志物和液体活检的潜在靶点，使其成为一种有前景的未来筛查工具。
