The role of inflammation and autoimmunity in the pathophysiology of pulmonary arterial hypertension.

Nada Kherbeck, Mathieu C Tamby, Guillaume Bussone, Hanadi Dib, Frederic Perros, Marc Humbert, Luc Mouthon

Institut Cochin, INSERM U1016, Paris, France.

Clinical reviews in allergy & immunology 2013 Feb

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Pulmonary arterial hypertension is characterized by a remodeling of pulmonary arteries with endothelial cell, fibroblast, and vascular smooth muscle cell activation and proliferation. Since pulmonary arterial hypertension occurs frequently in autoimmune conditions such as systemic sclerosis, inflammation and autoimmunity have been suspected to play a critical role in both idiopathic pulmonary arterial hypertension and systemic sclerosis-associated pulmonary arterial hypertension. High levels of pro-inflammatory cytokines such as interleukin-1 and interleukin-6, platelet-derived growth factor, or macrophage inflammatory protein 1 have been found in lung samples of patients with pulmonary arterial hypertension, along with inflammatory cell infiltrates mainly composed of macrophages and dendritic cells, T and B lymphocytes. In addition, circulating autoantibodies are found in the peripheral blood of patients. Thus, autoimmunity and inflammation probably play a role in the development of pulmonary arterial hypertension. In this setting, it would be important to set-up new experimental models of pulmonary arterial hypertension, in order to define novel therapeutics that specifically target immune disturbances in this devastating condition.

Citation

Nada Kherbeck, Mathieu C Tamby, Guillaume Bussone, Hanadi Dib, Frederic Perros, Marc Humbert, Luc Mouthon. The role of inflammation and autoimmunity in the pathophysiology of pulmonary arterial hypertension. Clinical reviews in allergy & immunology. 2013 Feb;44(1):31-8